The use of various materials and drugs for the prevention of the development of postoperative lumbar epidural fibrosis: literature review

The paper is a review of the current literature data on the use of various materials and drugs for the prevention of the development of postoperative lumbar epidural fibrosis. Literature searches were performed in the Pubmed, Medline, EMBASE, Cochrane Library and eLibrary databases. The formation and growth of fibrous tissue in the epidural space, followed by tissue adhesion to the dura mater, is the leading cause of pain afferentation in the lumbar spine and/or lower extremities. Several molecular and cellular mechanisms play an important role in the pathophysiology of connective tissue formation in the epidural space. An analysis of experimental and clinical studies examining the effectiveness of various materials and drugs is presented. The authors present the current data on new therapeutic approaches to the prevention of postoperative epidural fibrosis. Topical, unresolved issues which necessitate further research on the pathophysiology of epidural fibrosis are indicated.