背景:椎板切除术后神经根中硬膜外纤维化的过度产生可能是疼痛的根源。药物治疗是一种微创治疗选择,通过抑制成纤维细胞的增殖和活化来减轻硬膜外纤维化,炎症,和血管生成,诱导细胞凋亡。
目的:我们回顾并列出了各自的信号轴与减少硬膜外纤维化有关的药物。此外,我们总结了目前有关新型生物制剂和microRNA减轻硬膜外纤维化可行性的文献。
方法:系统评价方法:根据PRISMA指南,我们系统回顾了2022年10月的文献。排除标准包括重复,不相关的文章,药物机制的细节不足。
结果:我们从PubMed和Embase数据库共获得2,499篇文章。筛选文章后,最终选择74篇文章进行系统评价,并根据药物和microRNA的功能进行分类,包括抑制成纤维细胞增殖和激活,促凋亡,抗炎,和抗血管生成。此外,我们总结了预防硬膜外纤维化的各种途径。
结论:本研究对预防椎板切除术中硬膜外纤维化的药物治疗进行了全面综述。
结论:我们希望我们的综述能使研究人员和临床医生更好地了解抗纤维化药物在硬膜外纤维化治疗临床应用中的作用机制。
Excessive production of epidural fibrosis in the nerve root can be a pain source after laminectomy. Pharmacotherapy is a minimally invasive treatment option to attenuate epidural fibrosis by suppressing proliferation and activation of fibroblasts, inflammation, and angiogenesis, and inducing apoptosis.
We reviewed and tabulated pharmaceuticals with their respective signaling axes implicated in reducing epidural fibrosis. Additionally, we summarized current literature for the feasibility of novel biologics and microRNA to lessen epidural fibrosis.
Systematic
Review.
According to the PRISMA guidelines, we systematically reviewed the literature in October 2022. The exclusion criteria included duplicates, nonrelevant articles, and insufficient detail of drug mechanism.
We obtained a total of 2,499 articles from PubMed and Embase databases. After screening the articles, 74 articles were finally selected for the systematic
review and classified based on the functions of drugs and microRNAs which included inhibition of fibroblast proliferation and activation, pro-apoptosis, anti-inflammation, and antiangiogenesis. In addition, we summarized various pathways to prevent epidural fibrosis.
This study allows a comprehensive
review of pharmacotherapies to prevent epidural fibrosis during laminectomy.
We expect that our
review would enable researchers and clinicians to better understand the mechanism of anti-fibrosis drugs for the clinical application of epidural fibrosis therapies.