Prevention of postoperative epidural fibrosis: current status of the issue

Abstract

Epidural fibrosis is a common cause of a failed back surgery syndrome. The current scientific literature proposed many methods for prevention of epidural fibrosis, however, universal methods to fully solve the problem was not found. Prevention tasks in the preoperative period include the identification of risk factors for the development of epidural fibrosis with the correction of the revealed violations. Intraoperative prevention involves the development of barriers in the form of natural and synthetic polymeric materials that impede the formation of epidural fibrosis after laminectomy. The complex of measures to prevent the development of epidural fibrosis in the postoperative period is supposed to include a list of manipulations consisting of epidural blockades with a common complex anti-inflammatory drug therapy. The study presents an analysis of 63 literary sources from PubMed, EMBASE, Cochrane Library, and eLIBRARY databases most fully reflecting the pathogenetically substantiated prevention of the epidural fibrosis development in the preoperative, intraoperative and postoperative periods.