The effect of NSAIDs on spinal fusion: a cross-disciplinary review of biochemical, animal, and human studies

Purpose Non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in postoperative pain management. However, their use in the setting of spine fusion surgery setting has long been a topic of controversy. In this review we examined relevant research, including in vivo, animal, and clinica...

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Bibliographic Details
Published in:European spine journal 2017-11, Vol.26 (11), p.2719-2728
Main Authors: Sivaganesan, Ahilan, Chotai, Silky, White-Dzuro, Gabrielle, McGirt, Matthew J., Devin, Clinton J.
Format: Article
Language:English
Subjects:
Analgesia
Animals
Anti-Inflammatory Agents, Non-Steroidal - administration & dosage
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Bone healing
Bone surgery
Clinical trials
Dose dependency
Fracture Healing
Humans
Inflammation
Medicine
Medicine & Public Health
Neurosurgery
Nonsteroidal anti-inflammatory drugs
Nonunion
Opioids
Pain
Pain, Postoperative - drug therapy
Review Article
Spinal Fractures - surgery
Spinal Fusion - methods
Spine
Studies
Surgery
Surgical Orthopedics
Treatment Outcome
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Summary:Purpose Non-steroidal anti-inflammatory drugs (NSAIDs) play an important role in postoperative pain management. However, their use in the setting of spine fusion surgery setting has long been a topic of controversy. In this review we examined relevant research, including in vivo, animal, and clinical human studies, with the aim of understanding the effect of NSAIDs on spinal fusion. Study design/setting Systematic review of study designs of all types from randomized controlled trials and meta-analyses to single-institution retrospective reviews. Methods A search of PubMed and Embase was conducted using the keywords: “spine,” “spinal fracture,” NSAIDs, anti-inflammatory non-steroidal agents, bone, bone healing, fracture, fracture healing, yielding a total of 110 studies. Other 28 studies were identified by cross-referencing, resulting in total 138 studies. Results There is no level I evidence from human studies regarding the use of NSAIDs on spinal fusion rates. The overall tone of the spine literature in the early 2000s was that NSAIDs increased the rate of non-union; however, nearly all human studies published after 2005 suggest that short-term (
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-017-5021-y