Unlocking the Healing Potential: Cannabinoids in Spine Surgery for Pain Relief and Recovery.

IF 1.7 Q2 SURGERY JBJS Reviews Pub Date : 2023-11-16 eCollection Date: 2023-11-01 DOI:10.2106/JBJS.RVW.23.00141
Hania Shahzad, Maximillian Lee, Vikas Munjal, Cole Veliky, Elizabeth Yu
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Abstract

» Cannabinoids, such as D9-tetrahydrocannabinol and cannabidiol, interact with endocannabinoid receptors in the central nervous system and immune system, potentially offering pain relief. The entourage effect, resulting from the interaction of multiple cannabis components, may enhance therapeutic impact and efficacy, making them promising candidates for exploring pain relief in spine operations, known to be among the most painful operative procedures.» The use of cannabinoids in pain management requires careful consideration of safety, including their cognitive and psychomotor effects, potential cardiovascular risks, risk of dependence, mental health implications, and drug interactions.» Few studies have analyzed cannabinoid use in relation to spine surgery, with variable results reported, indicating possible effects on reoperation rates, mortality, complications, postoperative opioid use, and length of hospital stay.» Current knowledge gaps exist in the understanding of cannabinoid effects on spine surgery, including the exploration of different administration routes, timing, dosage, and specific outcomes. In addition, mechanistic explanations for the observed results are lacking.» Ethical considerations related to informed consent, medical expertise, societal impact, and legal compliance must also be thoroughly addressed when considering the utilization of cannabinoids in spinal pathologies and back pain treatment.

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解锁愈合潜力:大麻素在脊柱外科疼痛缓解和恢复。
大麻素,如d9 -四氢大麻酚和大麻二酚,与中枢神经系统和免疫系统中的内源性大麻素受体相互作用,可能会缓解疼痛。由多种大麻成分相互作用产生的伴随效应可能增强治疗效果和疗效,使其成为探索脊柱手术中疼痛缓解的有希望的候选者,已知脊柱手术是最痛苦的手术程序之一。»在疼痛管理中使用大麻素需要仔细考虑安全性,包括其认知和精神运动效应、潜在心血管风险、依赖风险、心理健康影响和药物相互作用。»很少有研究分析大麻素使用与脊柱手术的关系,报告的结果不一,表明可能对再手术率、死亡率、并发症、术后阿片类药物使用和住院时间的影响。目前对大麻素对脊柱手术的影响的认识存在空白,包括对不同给药途径、时间、剂量和具体结果的探索。此外,还缺乏对观测结果的机制解释。»在考虑大麻素在脊柱疾病和背痛治疗中的应用时,也必须彻底解决与知情同意、医学专业知识、社会影响和法律合规性相关的伦理考虑。
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来源期刊
JBJS Reviews
JBJS Reviews SURGERY-
CiteScore
4.40
自引率
4.30%
发文量
132
期刊介绍: JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.
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