Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review
Postoperative epidural fibrosis (EF) is still a major limitation to the success of spine surgery. Fibrotic adhesions in the epidural space, initiated via local trauma and inflammation, can induce difficult-to-treat pain and constitute the main cause of failed back surgery syndrome, which not uncommo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2024-03-01
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| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0106/_pdf/-char/en |
| _version_ | 1797215588306649088 |
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| author | Guido Lewik Gerrit Lewik Lena S. Müller Alexander von Glinski Tobias L. Schulte Tobias Lange |
| author_facet | Guido Lewik Gerrit Lewik Lena S. Müller Alexander von Glinski Tobias L. Schulte Tobias Lange |
| author_sort | Guido Lewik |
| collection | DOAJ |
| description | Postoperative epidural fibrosis (EF) is still a major limitation to the success of spine surgery. Fibrotic adhesions in the epidural space, initiated via local trauma and inflammation, can induce difficult-to-treat pain and constitute the main cause of failed back surgery syndrome, which not uncommonly requires operative revision.
Manifold agents and methods have been tested for EF relief in order to mitigate this longstanding health burden and its socioeconomic consequences. Although several promising strategies could be identified, few have thus far overcome the high translational hurdle, and there has been little change in standard clinical practice. Nonetheless, notable research progress in the field has put new exciting avenues on the horizon.
In this review, we outline the etiology and pathogenesis of EF, portray its clinical and surgical presentation, and critically appraise current efforts and novel approaches toward enhanced prevention and treatment. |
| first_indexed | 2024-04-24T11:32:27Z |
| format | Article |
| id | doaj.art-d0e163eb80f04843a24502e370fb60b3 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-24T11:32:27Z |
| publishDate | 2024-03-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-d0e163eb80f04843a24502e370fb60b32024-04-10T08:13:49ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2024-03-018213314210.22603/ssrr.2023-01062023-0106Postoperative Epidural Fibrosis: Challenges and Opportunities - A ReviewGuido Lewik0Gerrit Lewik1Lena S. Müller2Alexander von Glinski3Tobias L. Schulte4Tobias Lange5Department of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University BochumDepartment of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University BochumDepartment of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University BochumDepartment of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University BochumDepartment of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University BochumPostoperative epidural fibrosis (EF) is still a major limitation to the success of spine surgery. Fibrotic adhesions in the epidural space, initiated via local trauma and inflammation, can induce difficult-to-treat pain and constitute the main cause of failed back surgery syndrome, which not uncommonly requires operative revision. Manifold agents and methods have been tested for EF relief in order to mitigate this longstanding health burden and its socioeconomic consequences. Although several promising strategies could be identified, few have thus far overcome the high translational hurdle, and there has been little change in standard clinical practice. Nonetheless, notable research progress in the field has put new exciting avenues on the horizon. In this review, we outline the etiology and pathogenesis of EF, portray its clinical and surgical presentation, and critically appraise current efforts and novel approaches toward enhanced prevention and treatment.https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0106/_pdf/-char/enepidural fibrosisperidural fibrosisepidural adhesionsperidural adhesionslaminectomyfailed back surgery syndromeepiduroscopyepidural adhesiolysisepidurolysis |
| spellingShingle | Guido Lewik Gerrit Lewik Lena S. Müller Alexander von Glinski Tobias L. Schulte Tobias Lange Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review Spine Surgery and Related Research epidural fibrosis peridural fibrosis epidural adhesions peridural adhesions laminectomy failed back surgery syndrome epiduroscopy epidural adhesiolysis epidurolysis |
| title | Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review |
| title_full | Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review |
| title_fullStr | Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review |
| title_full_unstemmed | Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review |
| title_short | Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review |
| title_sort | postoperative epidural fibrosis challenges and opportunities a review |
| topic | epidural fibrosis peridural fibrosis epidural adhesions peridural adhesions laminectomy failed back surgery syndrome epiduroscopy epidural adhesiolysis epidurolysis |
| url | https://www.jstage.jst.go.jp/article/ssrr/8/2/8_2023-0106/_pdf/-char/en |
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