Complex regional pain syndrome after spinal fusion is a controversial topic that not all health care providers agree on. Complex regional pain syndrome, or CRPS, is a condition characterized by severe pain that may occur after a person experiences an injury. Spinal fusion is a type of surgical procedure that may be performed when a surgeon wants to correct problems related to the spine’s small bones, or vertebrae.
Is There a Link?
Complex regional pain syndrome after spinal fusion is believed to occur in some patients. While CRPS typically occurs as a result of an injury, in rare cases, it may develop after a patient has surgery. If during spinal fusion surgery a nerve is damaged, it may result in this condition. When a nerve is damaged, it becomes unable to feel, control blood flow or control temperature to the area that is affected. This can result in medical problems in the bones, nerves, blood vessels, muscles and skin. The arms and legs are most often affected by pain, though, other areas of the body have been reported to be affected.
Understanding Spinal Fusion Surgery
Spinal fusion may be performed to help in relieving the signs and symptoms of a number of back conditions, including spondylolisthesis, scoliosis, infection, degenerative disc disease, spinal stenosis, fracture or a tumor. This surgery will fuse together two vertebrae in the spine, eliminating motion between them. This also prevents the nerves and surrounding muscles and ligaments from stretching. The theory behind this surgery is that motion causes pain, so preventing the motion by fusing the vertebrae should relieve the pain.
CRPS Signs and Symptoms
Intense pain that tends to become more intense over time is the main symptom of this condition. In the arm, hand, leg or foot, the patient may experience a burning pain. Nail or hair growth may change. The affected body part may have decreased mobility and be harder to move. Muscle weakness, spasms and atrophy may occur. Joints may become damaged, swollen or stiff. Skin may become sensitive, or may have changes in color, texture and temperature.
Can CRPS be Treated?
If a patient receives treatment within a few months of symptom onset, remission or dramatic symptom improvement are possible. A combination of treatments are often necessary for best results. Medications are commonly used. Commonly prescribed medications include OTC non-steroidal anti-inflammatory drugs for pain and inflammation. Pain related to nerve damage may be relieved by a variety of prescription antidepressants or anti-seizure medications, such as amitriptyline or gabapentin. To reduce inflammation, corticosteroids, like prednisone, may be beneficial. For more severe pain, patients may be prescribed opioid medications. Doctors may also suggest calcitonin, alendronate or another bone-loss medication.
Other therapies that may help in alleviating the pain may include applying cold and heat, physical therapy, transcutaneous electrical nerve stimulation, spinal cord stimulation, topical analgesics, sympathetic nerve-blocking medication and biofeedback.
Family Doctor. (1999). Complex Regional Pain Syndrome. Retrieved on March 22, 2011 from Family Doctor: https://familydoctor.org/online/famdocen/home/common/pain/disorders/238.html
American Association of Orthopedic Surgeons. (2010). Spinal Fusion. Retrieved on March 22, 2011 from the American Association of Orthopedic Surgeons: https://orthoinfo.aaos.org/topic.cfm?topic=a00348