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Background/Purpose <p>Epidural fibrosis is a common postoperative complication of lumbar spine surgery and may cause persistent pain and functional limitation. Although various anti-adhesive materials have been introduced, their clinical effectiveness remains uncertain. Acellular dermal matrix (ADM), a biologically derived scaffold with favorable biocompatibility, may help prevent postoperative adhesions. This study evaluated the clinical efficacy and safety of ADM following posterior lumbar interbody fusion (PLIF).</p> Methods <p>This retrospective study included patients who underwent single-level PLIF for degenerative lumbar disease between July 2019 and January 2023. Patients were assigned to ADM and non-ADM groups based on intraoperative ADM use. Propensity score matching was performed to reduce baseline differences. Outcomes were assessed using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria.</p> Results <p>After matching, 66 patients (33 per group) were analyzed, with a mean follow-up of 18.6 months. Both groups showed significant postoperative improvement. The ADM group demonstrated lower VAS back pain scores at 6 months (p = 0.02) and 12 months (p &lt; 0.01), and lower ODI scores at 12 months (p = 0.03). Satisfactory outcomes were achieved in 93.9% of the ADM group and 87.9% of the non-ADM group. Radiologic evaluation in the ADM group demonstrated preservation of a distinct tissue layer over the thecal sac, consistent with a barrier effect. No ADM-related adverse events were observed.</p> Conclusion <p>ADM use during lumbar fusion surgery was associated with improved pain control and functional outcomes without additional safety concerns. ADM may be a useful option for preventing epidural fibrosis. Further prospective studies are warranted.</p>

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Efficacy and Safety of Acellular Dermal Matrix for Prevention of Epidural Fibrosis after Lumbar Fusion Surgery: A Propensity Score-Matched Study

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Dong Hun Kim,
  • Jin-Young Kim,
  • Jae Taek Hong,
  • Jung-Woo Hur

摘要

Background/Purpose

Epidural fibrosis is a common postoperative complication of lumbar spine surgery and may cause persistent pain and functional limitation. Although various anti-adhesive materials have been introduced, their clinical effectiveness remains uncertain. Acellular dermal matrix (ADM), a biologically derived scaffold with favorable biocompatibility, may help prevent postoperative adhesions. This study evaluated the clinical efficacy and safety of ADM following posterior lumbar interbody fusion (PLIF).

Methods

This retrospective study included patients who underwent single-level PLIF for degenerative lumbar disease between July 2019 and January 2023. Patients were assigned to ADM and non-ADM groups based on intraoperative ADM use. Propensity score matching was performed to reduce baseline differences. Outcomes were assessed using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria.

Results

After matching, 66 patients (33 per group) were analyzed, with a mean follow-up of 18.6 months. Both groups showed significant postoperative improvement. The ADM group demonstrated lower VAS back pain scores at 6 months (p = 0.02) and 12 months (p < 0.01), and lower ODI scores at 12 months (p = 0.03). Satisfactory outcomes were achieved in 93.9% of the ADM group and 87.9% of the non-ADM group. Radiologic evaluation in the ADM group demonstrated preservation of a distinct tissue layer over the thecal sac, consistent with a barrier effect. No ADM-related adverse events were observed.

Conclusion

ADM use during lumbar fusion surgery was associated with improved pain control and functional outcomes without additional safety concerns. ADM may be a useful option for preventing epidural fibrosis. Further prospective studies are warranted.