医学
纤维化
血管生成
椎板切除术
细胞凋亡
炎症
体内
药理学
生物信息学
癌症研究
病理
内科学
脊髓
生物化学
化学
生物技术
精神科
生物
作者
Venkateswaran Ganesh,Yochana Kancherla,Cassim Igram,Andrew J. Pugely,Aliasger K. Salem,Kyungsup Shin,Tae‐Hong Lim,Dongrim Seol
标识
DOI:10.1016/j.spinee.2023.05.007
摘要
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.
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