BACKGROUND: The association between epidural @entity82 and recurrent symptoms after lumbar spine surgery remains a matter of debate in scientific literature and the underlying pathophysiological mechanism has not been clearly elucidated. OBJECTIVE: To investigate the presence of nerve fibers and the expression of @entity1096 in epidural fibrous tissue after lumbar surgery in @entity1 . STUDY DESIGN: Laboratory study of @entity1 tissue samples. METHODS: Twenty-four @entity1 with persistent or recurrent @entity1643 after lumbar spine surgery, in whom no relevant findings were present on magnetic resonance imaging (MRI) besides @entity3145 , were submitted to epiduroscopy. Biopsy samples of @entity3145 resting in the posterior epidural and periradicular space were obtained from 15 @entity1 , using an endoscopic grasping forceps, in locations where the stimulation with the tip of a Fogarty consistently reproduced @entity158 . Biopsy samples were processed for examination under optical and transmission electron microscopes and under a fluorescence microscope after incubation in primary antibodies against beta3-tubulin or against @entity1096 . RESULTS: Optical and transmission electron microscopy revealed a homogeneous fibrous tissue rich in collagen and lacking nerve fibers. No immunofluorescence was present in any of the samples immunoreacted against beta3-tubulin. In the samples immunoreacted against @entity1096 , a punctate signal was detected around the collagen fibers. LIMITATIONS: Being a @entity1 study, there was no control group, so it is not possible to determine the contribution of @entity1096 in the formation of epidural @entity82 and its relation to the @entity1 ' symptoms. Additional animal studies are needed to investigate these issues. CONCLUSION: Rather than direct stimulation of nociceptors in the @entity3145 , other factors should relate epidural @entity82 and recurrent symptoms after lumbar spine surgery. @entity1096 seems to play a role in the formation of epidural @entity82 .

New insights from immunohistochemistry for the characterization of XXXX .

@entity1 :: ('9606', 'Species') :: ['humans', 'human', 'patients'] @entity1643 :: ('MESH:D017116', 'Disease') :: ['low back and/or leg pain'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity3145 :: ('MESH:D017695', 'Disease') :: ['epidural scar tissue'] @entity1096 :: ('6696', 'Gene') :: ['osteopontin', 'Osteopontin'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity3145 :: (MESH:D017695,Disease) :: ['epidural scar tissue']
