Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review

DOI Web Site 96 References
  • Lewik Guido
    Department of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum
  • Lewik Gerrit
    Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum
  • Müller Lena S.
    Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum
  • von Glinski Alexander
    Department of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum
  • Schulte Tobias L.
    Department of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum
  • Lange Tobias
    Department of Orthopedics and Trauma Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum

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<p>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.</p><p>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.</p><p>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.</p>

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