Complex Regional Pain Syndrome after Spine Surgery: A Rare Complication in Mini-Invasive Lumbar Spine Surgery: An Updated Comprehensive Review

Abstract

Background: Complex regional pain syndrome (CRPS) is a postoperative, misdiagnosed condition highlighted only by pain therapists after numerous failed attempts at pain control by the treating surgeon in the case of prolonged pain after surgery. It only occurs rarely after spine surgery, causing the neurosurgeon’s inappropriate decision to resort to a second surgical treatment. Methods: We performed a systematic review of the literature reporting and analyzing all recognized and reported cases of CRPS in patients undergoing spinal surgery to identify the best diagnostic and therapeutic strategies for this unusual condition. We compare our experience with the cases reported through a review of the literature. Results: We retrieve 20 articles. Most of the papers are clinical cases showing the disorder’s rarity after spine surgery. Most of the time, the syndrome followed uncomplicated lumbar spine surgery involving one segment. The most proposed therapy was chemical sympathectomy and spinal cord stimulation. Conclusion: CRPS is a rare pathology and is rarer after spine surgery. However, it is quite an invalidating disorder. Early therapy and resolution, however, require a rapid diagnosis of the syndrome. In our opinion, since CRPS occurs relatively rarely following spinal surgery, it should not have a substantial impact on the indications for and timing of these operations. Therefore, it is essential to diagnose this rare occurrence and treat it promptly and appropriately.

NMDA Receptors Regulate Oxidative Damage in Keratinocytes during Complex Regional Pain Syndrome in HaCaT Cells and Male Rats

“…These changes result in substantial functional impairment and disability, which can have a significant effect on daily life [2,3]. Furthermore, it is worth noting that acute stressors, such as significant nociceptive stimuli and surgical procedures, can elicit a hyperinflammatory response and potentially trigger the development of CRPS following trauma [4]. Although the mechanisms of CRPS are complex and remain poorly understood, potential mechanisms are believed to involve peripheral and central sensitization, systemic inflammation, autonomic dysfunction, and neuroinflammation [5][6][7][8][9].…”