Pain medication use after spine surgery.

Dear Editor: Spine surgery is one of the most difficult areas in which to achieve a good clinical outcome after surgery. When compared with the other orthopedic subspecialties, such as joint replacement surgery, a higher percentage of postoperative patients continue to have symptoms that require pain medication utilization and some require further surgeries. Failure rates associated with lumbar fusion surgeries range from 10% to 40% [1]. This high rate of unsuccessful spine surgery has generated the term “failed back surgery syndrome.” Strong indications for spine surgery are instability of the spine and neurological deficits including motor deficit and bladder and bowel dysfunction, while pain remains strictly a relative indication. However, an increasing number of spine surgeries are recently being performed based mainly on pain symptoms. The use of postoperative pain medication following spine surgery is nearly universal. However, despite the prevalence of use, there is no standardized protocol detailing the type, strength, or duration of pain medication use following specific procedures. Optimally, surgery should relieve the symptoms that brought the patient to …