The effects of preoperative analgesic medications on postoperative pain and disability following spinal surgery for degenerative cervical spine conditions

Abstract

Background: Neurological pain is a leading public health challenge. Two common cervical neurological conditions are myelopathy and radiculopathy, caused by compression and inflammation of the spinal cord, or a cervical nerve root, respectively. Patients are often treated with nonoperative and operative interventions; however, some patients do not experience satisfactory clinical outcomes. Aim: To investigate the association of preoperative analgesic medications (Muscle Relaxants, Neuroleptics, Narcotics, Over-the-Counter medications, and NSAIDs) with postoperative neck/arm pain and disability. Study Design: Longitudinal and retrospective analysis of 539 patients with cervical radiculopathy and 609 patients with cervical myelopathy. Data Analysis: Propensity score models using inverse probability weighting and regression adjustments were performed to determine the effects of preoperative analgesics on postoperative clinical outcomes. Results: Preoperative analgesics had no clinically relevant effects on postoperative pain or disability. However, decision-making around analgesic use is complex and the long-term effects on patients’ overall health should be considered.