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Surgical Technique Prevents Nerve Pain After Back Surgery

Prevention and management of postoperative neuralgia reviewed

THURSDAY, April 10 (HealthDay News) -- Postoperative nerve pain after posterior lumbar interbody fusion surgery (PLIF) can be prevented with careful surgical technique, according to an article published in the March/April issue of the Spine Journal.

Manoj Krishna, of the University Hospital of North Tees in Stockton on Tees, United Kingdom, and colleagues investigated the incidence and etiology of neuralgia after PLIF by retrospectively reviewing data from 226 patients who underwent the procedure for degenerative disc disease, spondylolisthesis, disc herniation, and postlaminectomy/postdiscectomy syndrome. The authors then outlined strategies for prevention and management of the complication.

Postoperative neuralgia occurred in 7.1 percent of patients, including 9.7 of those who underwent subtotal facetectomy and 4.9 percent of those who underwent total facetectomy, the researchers report. Nerve root swelling after surgery and relative stenosis were the most common causes of postoperative neuralgia, with misplaced screws also leading to the complication, the report indicates. Persistent neuralgia, despite intervention, was seen in 2.7 percent of patients.

The authors outlined a surgical protocol for preventing postoperative neuralgia, including the use of total facetectomy and the necessity of adequate decompression of the lateral recess above the disc. "With careful attention to technique and detail, post-PLIF neuralgia is a preventable complication," they conclude.

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