[Postoperative epidural fibrosis after lumbar disc surgery: fact or fiction?]

Recurrent radiculopathy after lumbar microdiscectomy may decrease the quality of life of operated patients. Epidural fibrosis is considered to be one of the mechanisms that could be responsible for the pain. Therefore, the use of a resorbable gel to separate the lumbar nerve roots from the surrounding bone, muscles and disc remnants, could reduce scarring and postoperative pain, improve clinical outcome and make revision surgery easier. We reviewed the literature about efficacy and complications of adhesion prevention in the lumbar spine. Although the first attempts to achieve adhesion prevention were not conclusive, the results of the most recent trials about polyethylene oxide/carboxymethylcellulose based or polyethylene glycol based gels provide encouraging safety evidences and promising efficacy results.