DOI QR코드

DOI QR Code

Cryo-Compression Therapy After Elective Spinal Surgery for Pain Management: A Cross-Sectional Study With Historical Control

  • Nabiyev, Vugar Nabi (Department of Orthopaedics, ARTES Spine Center, Acibadem Ankara Hospital) ;
  • Ayhan, Selim (Department of Neurosurgery, ARTES Spine Center, Acibadem Ankara Hospital) ;
  • Adhikari, Prashant (Department of Orthopaedics, ARTES Spine Center, Acibadem Ankara Hospital) ;
  • Cetin, Engin (Department of Orthopaedics and Traumatology, Gaziosmanpasa Taksim Training and Research Hospital) ;
  • Palaoglu, Selcuk (Department of Neurosurgery, ARTES Spine Center, Acibadem Ankara Hospital) ;
  • Acaroglu, R. Emre (Ankara Spine Center)
  • Received : 2018.03.06
  • Accepted : 2018.08.19
  • Published : 2018.12.31

Abstract

Objective: Postoperative dynamic cryo-compression (DC) therapy has been proposed as a method of reducing pain and the inflammatory response in the early postoperative period after orthopedic joint reconstruction surgery. Our aim was to analyze the analgesic efficacy of DC therapy after adult lumbar spinal surgery. Methods: DC was applied for 30 minutes every 6 hours after surgery. Pain was measured by a visual analogue scale (VAS) in the preoperative period, immediately after surgery, and every 6 hours postoperatively for the first 72 hours of the hospital stay. Patients' pain medication requirements were monitored using the patient-controlled analgesia system and patient charts. Twenty patients who received DC therapy were compared to 20 historical controls who were matched for demographic and surgical variables. Results: In the postanesthesia care unit, the mean VAS back pain score was $5.87{\pm}0.9$ in the DC group and $6.95{\pm}1.0$ (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were $3.8{\pm}1.1$ vs. $5.4{\pm}0.7$ (p < 0.001) at 6 hours postoperatively, and $2.7{\pm}0.7$ vs. $6.25{\pm}0.9$ (p<0.001) at discharge, respectively. The cumulative mean analgesic consumption of paracetamol, tenoxicam, and tramadol in the DC group vs. control group was $3,733.3{\pm}562.7mg$ vs. $4,633.3{\pm}693.5mg$ (p<0.005), $53.3{\pm}19.5mg$ vs. $85.3{\pm}33.4mg$ (p<0.005), and $63.3{\pm}83.4mg$ vs. $393.3{\pm}79.9mg$ (p<0.0001), respectively. Conclusion: The results of this study demonstrated a positive association between the use of DC therapy and accelerated improvement in patients during early rehabilitation after adult spine surgery compared to patients who were treated with painkillers only.

Keywords

References

  1. Kurd MF, Kreitz T, Schroeder G, et al. The role of multimodal analgesia in spine surgery. J Am Acad Orthop Surg 2017;25:260-8. https://doi.org/10.5435/JAAOS-D-16-00049
  2. Kluba T, Hofmann F, Bredanger S, et al. Efficacy of post-operative analgesia after posterior lumbar instrumented fusion for degenerative disc disease: a prospective randomized comparison of epidural catheter and intravenous administration of analgesics. Orthop Rev (Pavia) 2010;2:e9. https://doi.org/10.4081/or.2010.e9
  3. Dahan A, Olofsen E, Niesters M. Pharmacotherapy for pain: efficacy and safety issues examined by subgroup analyses. Pain 2015;156 Suppl 1:S119-26.
  4. Hubbard TJ, Denegar CR. Does cryotherapy improve outcomes with soft tissue injury? J Athl Train 2004;39:278-9.
  5. Khanna A, Gougoulias N, Maffulli N. Intermittent pneumatic compression in fracture and soft-tissue injuries healing. Br Med Bull 2008;88:147-56. https://doi.org/10.1093/bmb/ldn024
  6. Waterman B, Walker JJ, Swaims C, et al. The efficacy of combined cryotherapy and compression compared with cryotherapy alone following anterior cruciate ligament reconstruction. J Knee Surg 2012;25:155-60. https://doi.org/10.1055/s-0031-1299650
  7. Crystal NJ, Townson DH, Cook SB, et al. Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol 2013;113:2577-86. https://doi.org/10.1007/s00421-013-2693-9
  8. Katz J, Melzack R. Measurement of pain. Surg Clin North Am 1999;79:231-52. https://doi.org/10.1016/S0039-6109(05)70381-9
  9. Devin CJ, McGirt MJ. Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes. J Clin Neurosci 2015;22:930-8. https://doi.org/10.1016/j.jocn.2015.01.003
  10. Raynor MC, Pietrobon R, Guller U, et al. Cryotherapy after ACL reconstruction: a meta-analysis. J Knee Surg 2005;18:123-9. https://doi.org/10.1055/s-0030-1248169
  11. Morsi E. Continuous-flow cold therapy after total knee arthroplasty. J Arthroplasty 2002;17:718-22. https://doi.org/10.1054/arth.2002.33562
  12. Barber FA, McGuire DA, Click S. Continuous-flow cold therapy for outpatient anterior cruciate ligament reconstruction. Arthroscopy 1998;14:130-5. https://doi.org/10.1016/S0749-8063(98)70030-1
  13. Murgier J, Cailliez J, Wargny M, et al. Cryotherapy with dynamic intermittent compression improves recovery from revision total knee arthroplasty. J Arthroplasty 2017;32:2788-91. https://doi.org/10.1016/j.arth.2017.03.052
  14. Murata K, Yoshimoto M, Takebayashi T, et al. Effect of cryotherapy after spine surgery. Asian Spine J 2014;8:753-8. https://doi.org/10.4184/asj.2014.8.6.753
  15. Fountas KN, Kapsalaki EZ, Johnston KW, et al. Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling. Spine (Phila Pa 1976) 1999;24:1958-60. https://doi.org/10.1097/00007632-199909150-00016

Cited by

  1. Ice therapy: cool, current and complicated vol.61, pp.5, 2018, https://doi.org/10.1111/jsap.13130
  2. Evidence based veterinary medicine: a practice based example vol.36, pp.7, 2021, https://doi.org/10.1080/17415349.2021.1916417
  3. Effect of applying cold gel pack on reduction of postoperative pain in cesarean section, low midline skin incision: A randomized controlled trial vol.47, pp.8, 2021, https://doi.org/10.1111/jog.14855
  4. Reproducibility of Skin Temperature Response after Cold Stress Test Using the Game Ready System: Preliminary Study vol.18, pp.16, 2018, https://doi.org/10.3390/ijerph18168295
  5. Reporte de caso de postcirugía de ligamento cruzado anterior vol.3, pp.3, 2018, https://doi.org/10.21931/rb/2021.06.03.28