This study will compare two common approaches to pain control after lumbar spinal fusion surgery. Participants will be randomly assigned to receive either standard pain medication alone or standard pain medication plus a short course of nonsteroidal anti-inflammatory drugs (NSAIDs), including intravenous ketorolac while in the hospital and oral naproxen for one week after discharge.
The main goal is to determine whether taking NSAIDs after surgery affects how well the spine heals by increasing the chance of needing another surgery because the bones did not fuse properly within 2 years. The study will also evaluate pain medication use, recovery, hospital readmissions, complications, physical therapy progress, patient-reported pain and function, and overall healing. The results will help determine whether NSAIDs can be used safely as part of pain management after lumbar spinal fusion surgery while potentially reducing the need for opioid medications.
Inclusion Criteria:
Exclusion Criteria:
Surgeon will be blinded to which group each patient is in. Surgeons will make the determinations regarding clinical course, need for further workup, and assessment of fusion status on radiographs and advanced imaging. Patients will not be notified explicitly unless they ask, and they will not receive any form of placebo medication.
Participants will receive the institution's standard postoperative pain management regimen plus postoperative NSAID therapy consisting of intravenous ketorolac (15 mg every 6 hours for up to 48 hours while hospitalized) followed by oral naproxen (500 mg twice daily for 7 days after hospital discharge). If a participant is discharged before completing 48 hours of ketorolac therapy, no additional inpatient doses will be administered.
Participants will receive the institution's standard postoperative pain management regimen without postoperative NSAIDs. No placebo will be administered.
Philadelphia, Pennsylvania 19107, United States
Pre-Operative Ketamine Infusion for Post Operative Pain Control After Revision Spinal Surgery