Electrospun fibrous membranes provide suitable physical anti-adhesion barriers for reducing tissue anti-adhesion following surgery. However, often during the biodegradation process, these barriers trigger inflammation and cause a foreign body reaction with subsequent decrease in anti-adhesion efficacy. Here, a facile strategy comprising the incorporation of ibuprofen (IBU) into implantable membranes and its sustained release was proposed in order to improve anti-adhesion effects and neurological outcomes, namely to prevent failed back surgery syndrome (FBSS). The combination of free IBU and a newly synthetized polymeric prodrug of IBU, namely poly(hydroxyethyl methacrylate) with ester-linked IBU, was successfully used in order to reduce initial burst drug release and provide sustained drug release from fibrous membranes throughout several weeks. Such release profile was shown useful in preventing both acute and chronic inflammation in rats following laminectomy and membrane implantation. Moreover, histological analysis provided evidence of an excellent anti-adhesion effect, while associated neurological deficits were effectively reduced. Furthermore, the assessment of macrophage density, neovascularization, and related gene expression at the lesion site revealed that a sustained anti-inflammatory effect was achieved with the IBU-loaded proposed fibrous membranes. Results suggested that the COX2 pathway plays an important role in the development epidural fibrosis and arachnoiditis. Overall, this study provided evidence that precisely engineered IBU-loaded electrospun fibrous membranes may be useful in preventing FBSS and able to potentially impact the outcome of patients undergoing spine surgery.

电纺纤维膜可提供合适的物理抗粘连屏障，以减少手术后的组织抗粘连。但是，通常在生物降解过程中，这些屏障会引发炎症并引起异物反应，从而降低抗粘连功效。在此，提出了一种简便的策略，其中包括将布洛芬（IBU）掺入可植入膜中并持续释放，以改善抗粘连作用和神经系统结果，即预防失败的背部手术综合征（FBSS）。成功使用游离IBU和新合成的IBU聚合前药即聚甲基丙烯酸羟乙酯与酯连接的IBU的组合，以减少最初的突释药物释放并在数周内从纤维膜提供持续的药物释放。已显示这种释放曲线可用于预防椎板切除术和膜植入后大鼠的急性和慢性炎症。此外，组织学分析提供了优异的抗粘连作用的证据，而相关的神经功能缺损则得到有效减少。此外，对病变部位巨噬细胞密度，新生血管形成和相关基因表达的评估表明，使用载有IBU的建议纤维膜可实现持续的抗炎作用。结果表明，COX2通路在硬膜外纤维化和蛛网膜炎的发展中起着重要作用。全面的，