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Post-Laminectomy Syndrome  / Failed Back Syndrome

  1. Fusion hardware mediated low back pain. iSpine. Evidence Based Interventional Spine Care

  1. Non-operative management of postoperative neck pain following a fusion. Current Opinion in Orthopedics


Purpose of review: To critically review the available trials investigating the conservative management of postoperative neck pain after a cervical fusion.

Recent findings: A medical literature search was conducted using MEDLINE, OVID, PubMed, EMBASE, and MDConsult for articles published from January 2004 to January 2005 that incorporated these key words: cervical, neck, operation, postoperative, fusion, pain, spinal, treatment, and injections separately or in combination. All articles and abstracts on cervical spine fusion were included. Data were compiled for each of the following categories: documentation of technique, number of patients, outcome measures, follow-up intervals and results, and reported complications. No study was found that specifically addressed management of pain after cervical spine fusion surgery.

Summary:  Postoperative neck pain is expected to last a few days to a week. Prolonged neck pain should alert the physician to possible complications. After any potential complication has been ruled out, pain in the immediate postoperative period can be treated conservatively with neck immobilization, nonsteroidal anti-inflammatory drugs, narcotic medications, and physical therapy modalities. Asymptomatic nonunion may not require any treatment. Delayed union and nonunion may be treated with a bone stimulator. Pain due to adjacent level disc degeneration after fusion may be treated conservatively, with cervical transforaminal epidural injection or selective nerve root block, or with surgery.

Persistent Pain after Spine surgery