Post-Laminectomy Syndrome / Failed Back Syndrome
- Fusion hardware mediated low back pain. iSpine. Evidence Based Interventional Spine
Care
- Non-operative management of postoperative neck pain following a fusion. Current Opinion
in Orthopedics
Abstract
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.