| Ketorolac and spinal fusion: does the perioperative use of ketorolac really inhibit spinal fusion? | |
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MedLine Citation:
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PMID: 18698276 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate the effect of postoperative use of ketorolac (Toradol) on spinal fusion in humans. SUMMARY OF BACKGROUND DATA: The value of parenteral ketorolac in postoperative analgesia has been well documented across surgical specialties. However, some studies have shown that ketorolac may adversely affect osteogenic activity and fracture healing. METHODS: A total of 405 consecutive patients who underwent primary lumbar posterolateral intertransverse process fusion with pedicle screw instrumentation were included in this retrospective study. A subtotal of 228 patients received Toradol after surgery for adjunctive analgesia. Each patient received a mandatory dose of 30 mg intravenously every 6 hours for 48 hours. The same surgeon performed the fusion procedure on all of these patients. Historical controls included 177 patients who did not receive Toradol after surgery. The minimum follow-up period was 24 months. Nonunions were diagnosed by analyzing sequential radiographs, flexion-extension radiographs, and computed tomography with multiplanar reconstructions. The gold standard of surgical exploration was performed in symptomatic patients with diagnostic ambiguity or nonunions diagnosed by imaging. RESULTS: There were no smokers in the study population. Pseudarthrosis was identified in 12 of 228 patients (5.3%) who received Toradol after surgery, and in 11 of 177 patients (6.2%) who did not. There was no significant difference detected in the nonunion rates between the two groups (P > 0.05, chi2 method). CONCLUSION: Use of ketorolac after spinal fusion surgery in humans, limited to 48 hours after surgery for adjunctive analgesia, has no significant effect on ultimate fusion rates. |
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Authors:
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Ben B Pradhan; Robert L Tatsumi; Jason Gallina; Craig A Kuhns; Jeffrey C Wang; Edgar G Dawson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Spine Volume: 33 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2008 Sep |
Date Detail:
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Created Date: 2008-09-01 Completed Date: 2008-11-06 Revised Date: 2009-07-09 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 2079-82 Citation Subset: IM |
Affiliation:
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Risser Orthopaedic Group, Pasadena, CA 91107, USA. bpradhanb@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Inflammatory Agents, Non-Steroidal
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adverse effects,
therapeutic use* Bone Screws California / epidemiology Female Humans Injections, Intravenous Ketorolac / adverse effects, therapeutic use* Male Middle Aged Pain, Postoperative / prevention & control* Pseudarthrosis / chemically induced, epidemiology, etiology* Retrospective Studies Spinal Fusion* / instrumentation |
| Chemical | |
Reg. No./Substance:
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0/Anti-Inflammatory Agents, Non-Steroidal; 66635-83-4/Ketorolac |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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