PDF(Pubmed)
Abstract：
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.
摘要：
术后硬膜外纤维化（EF）仍然是脊柱手术成功的主要限制。硬膜外腔有纤维粘连，通过局部创伤和炎症引发，可诱发难以治疗的疼痛，并构成背部手术失败综合征的主要原因，这并不罕见地需要手术修正。为了减轻这种长期的健康负担及其社会经济后果，已经对歧管剂和方法进行了EF缓解测试。尽管可以确定几种有希望的策略，到目前为止，很少有人克服了高平移障碍，标准临床实践几乎没有变化。尽管如此，该领域的显着研究进展使新的令人兴奋的途径浮出水面。在这次审查中,我们概述了EF的病因和发病机制，描绘其临床和手术表现，并批判性地评估当前的努力和加强预防和治疗的新方法。
