Prevention and treatment of postoperative epidural scar adhesions

Zav’yalov, D. M.; Peretechikov, A V

doi:10.17116/neiro2016806115-117

Cited by 9 publications

(4 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the prevention of EF progression, the most commonly used and recommended technique that causes less tissue damage is microsurgery [8]. Given that microsurgery leads to less dead space in the paraspinal region and epidural area, it is likely to result in less scar tissue.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Curcumin and Methylprednisolone in Preventing Epidural Fibrosis After Spinal Surgery: An Experimental Study

Yildirim¹,

Yılmaz²,

Köktürk³

et al. 2020

Preprint

View full text Add to dashboard Cite

Aim:We aimed to compare the effectiveness of curcumin, which has been shown to inhibit cell migration and proliferation, with that of methylprednisolone, which has been shown to have a similar mechanism of action to that of curcumin and to delay tissue repair and wound healing, in the prevention of epidural fibrosis in an experimental laminectomy model in rats.Material and methods:The experiment was conducted with 40 male Wistar rats weighing 250-300 g which were divided into four groups. Laminectomy was performed from L1 to L4 in all groups. Curcumin and methylprednisolone were applied to the other two groups except the control and Dmso groups. The vertebral colon was excised en bloc and each section was examined for epidural fibrosis formation under a light microscope to evaluate histologically using the grading system.Results:The statistical analyses indicated that the treatment groups had a significant effect on the histological grades of epidural fibrosis in rats compared to the control group.Discussion:Curcumin, derived from the rhizome (Rhizoma Curcumae) of turmeric (Curcuma longa) was found to show a significant effect in the prevention of epidural fibrosis formation with its potent antioxidant and anti-inflammatory properties and by inhibiting further recruitment of fibroblasts to the laminectomy area.Conclusions:In the present study, both histological examination and statistical analyses indicated that the administration of curcumin led to a remarkable reduction in epidural fibrosis after laminectomy.

show abstract

Section: Resultsmentioning

confidence: 99%

Comparison of Curcumin and Methylprednisolone in Preventing Epidural Fibrosis After Spinal Surgery: An Experimental Study

Yildirim¹,

Yılmaz²,

Köktürk³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The methods used in the treatment of chronic lumbar radicular pain include medical analgesic drugs, centrally acting drugs (e.g., duloxetine and pregabalin, physical therapy and rehabilitation, lumbar epidural and transforaminal epidural steroid injections, dorsal root ganglion (DRG) pulse radiofrequency, and epidural lysis) [7]. A number of studies demonstrated the efficacy of epidural neuroplasty in the treatment of patients with persistent, chronic low back pain [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy of Caudal Epidural Neuroplasty in Patients With Lumbar Epidural Fibrosis

Ege

2024

Cureus

View full text Add to dashboard Cite

Introduction Lumbar and leg pain can be caused by many factors, including scar tissue in the epidural space. Epidural fibrosis may cause chronic radicular low back pain. Adhesions in the epidural space may occur due to surgical or non-surgical reasons. Epidural adhesiolysis, i.e., neuroplasty, eliminates the pain-causing effects of scar tissue by releasing the nerve from the scar tissue or decompressing the nerve. In light of this information, this study was conducted to evaluate the effectiveness of percutaneous epidural neuroplasty interventions performed in the algology clinic in patients with lumbar epidural fibrosis who have and have not undergone lumbar surgery. Methods The sample of this retrospective study consisted of 72 patients with chronic radicular low back pain, finding fibrosis in the epidural region on contrast-enhanced magnetic resonance imaging (MRI), filling defect after epidurogram, and caudal epidural neuroplasty. Patients' visual analog scale (VAS) and Oswestry disability index (ODI) scores, pregabalin, duloxetine, and opioid doses were evaluated before and one month and six months after having neuroplasty. Results The VAS and ODI scores and pregabalin, duloxetine, and opioid doses decreased significantly in patients who had had caudal epidural neuroplasty at post-procedure endpoints compared to before the procedure (p<0.001). The paired temporal comparisons of the data of the patients who underwent epidural neuroplasty procedures before the procedure, one month after the procedure, and six months after the procedure revealed significant differences in the VAS and ODI scores (p<0.001). Additionally, the analysis of patients' VAS scores revealed that the pre-procedure VAS scores decreased significantly more one month after the procedure in patients without a history of lumbar surgery than in patients with a history of lumbar surgery. Conclusions The findings of our study demonstrated that fluoroscopy-guided percutaneous epidural neuroplasty alleviated pain and improved physical functions and quality of life. In conclusion, percutaneous epidural neuroplasty is a safe and effective treatment method for patients with lumbar epidural fibrosis.

show abstract

“…Conservative treatment of symptomatic EF encompasses patient education, physiotherapy, analgesia with non-steroidal anti-inflammatory drugs, and injections of corticosteroid and local anesthetic agents. 86,87 Moreover, as recently reviewed, spinal cord stimulation has produced encouraging results in patients with FBSS. 88 EF symptoms refractory to conservative therapy can subsequently be addressed using two key approaches, namely fluid administration and mechanical release.…”

Section: Treatment Strategies (Conservative Interventional and Operat...mentioning

confidence: 99%

Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review

Lewik,

Müller

et al. 2024

Spine Surg Relat Res

View full text Add to dashboard Cite

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.

show abstract

Prevention and treatment of postoperative epidural scar adhesions

Cited by 9 publications

References 16 publications

Comparison of Curcumin and Methylprednisolone in Preventing Epidural Fibrosis After Spinal Surgery: An Experimental Study

Comparison of Curcumin and Methylprednisolone in Preventing Epidural Fibrosis After Spinal Surgery: An Experimental Study

Evaluation of the Efficacy of Caudal Epidural Neuroplasty in Patients With Lumbar Epidural Fibrosis

Postoperative Epidural Fibrosis: Challenges and Opportunities - A Review

Contact Info

Product

Resources

About