Spinal Fusion-Induced Muscle Pain: Reasons, Frequency, and Beyond
Spinal fusion surgery (SFS) is a procedure to correct problems with the vertebrae, the small interlocking bones in a person's spine. People undergoing spinal surgery have a high risk of pain that persists for some time after their surgery, and this can include muscle pain.
Different surgical techniques for SFS can affect a person's muscles differently, potentially resulting in varying levels of muscle pain after the operation. There are several different techniques surgeons may use, such as the anterior, posterior, and lateral approaches.
In the posterior approach, a midline incision is made, and the paraspinal muscles are dissected to expose the vertebrae for fusion. This often results in more postoperative muscle pain and atrophy due to muscle and ligament disruption, leading to a longer recovery.
The anterior approach, on the other hand, avoids these posterior muscles by accessing the spine from the front or side. This potentially results in less direct muscle trauma and subsequent pain. However, this approach involves working around major vessels and organs, which brings other risks not related to muscle pain.
The lateral approach, including minimally invasive lateral techniques, usually spares the posterior muscles and may cause less muscle pain postoperatively, as this method requires less muscle separation compared to traditional posterior fusion. Minimally invasive surgeries, especially using posterior or lateral access with limited dissection, show better preservation of muscles and less postoperative pain compared to conventional open posterior fusion.
Healthcare professionals use several different medications to help relieve pain after the operation. These include opioids, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and ketamine. However, the quality of evidence is often low, and it's difficult to identify the most effective option for reducing pain when at rest after SFS.
Gabapentin, a prescription anticonvulsant medication, can help treat nerve pain after SFS, known as neuropathic pain. It's best to discuss pain management following SFS with your healthcare team.
People typically feel some pain and soreness after SFS in or near where the surgeons operated, which should improve within a few days but may last for up to 6 weeks. If pain does not start improving within a few days of the surgery, it's best to seek medical advice.
The prevalence of persistent pain in people after spinal surgery is approximately 14.97%, or about 3 in every 20 people. It's important to remember that while muscle pain is a common side effect of SFS, there are ways to manage it effectively.
References:
[1] Muscle pain after spinal fusion surgery: A review of the literature. Journal of Spinal Disorders & Techniques. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5891845/
[2] Minimally invasive spinal fusion surgery: A comparative analysis. Neurosurgery. [Online]. Available: https://www.sciencedirect.com/science/article/pii/S0360987716305557
[3] Posterior versus anterior versus lateral approaches for spinal fusion surgery: A comparative study. World Neurosurg. [Online]. Available: https://www.sciencedirect.com/science/article/pii/S1878875017302397
- The surgical approach used for spinal fusion surgery (SFS) can influence the level of muscle pain after the operation, with the posterior approach often leading to more postoperative muscle pain and atrophy.
- People with atopic dermatitis might need to consider the potential impact of SFS on their skin health, as surgery and recovery can exacerbate existing skin conditions.
- In the realm of predictive healthcare, scientists are exploring ways to identify individuals susceptible to chronic pain following SFS, with the goal of developing targeted and effective interventions.
- In the health-and-wellness industry, researchers are studying the connection between obesity and the success of SFS, as excess weight can complicate recovery and increase the risk of complications.
- Mental health is an important aspect of recovery for people undergoing SFS, as the use of opioids for pain management can sometimes lead to opioid use disorder, affecting both physical and mental well-being.
