Texas researchers believe that they have discovered how to prevent many cases of the most common problem encountered by patients undergoing spine surgery: failed back surgery syndrome (FBSS).
FBSS occurs when surgery either fails to cure back pain or leads to additional chronic pain after a spinal operation.
In experiments using laboratory rats, neuroscientists at the University of Texas Medical Branch at Galveston (UTMB) applied the local anesthetic Lidocaine to the animals' exposed spinal cords before subjecting the rats to simulated spinal surgery. They found the procedure prevented both the release of chemicals associated with FBSS and behavior typical of animals experiencing FBSS-caused pain.
A paper describing their investigation is in press at the journal Experimental Neurology, and is available at the journal's Web site in the "Articles in Press" section.
"Our hypothesis is that the unintentional stretching and compression that can occur in the spinal cord during surgery causes the release of large quantities of chemicals called excitatory amino acids, which produce a toxic environment in the spine and cause long-term hyperexcitability in spinal neurons, generating chronic neuropathic pain - pain produced in the nerves themselves," said UTMB neuroscience and cell biology professor Claire Hulsebosch, a senior author of the paper along with UTMB neuroscience and cell biology professor David J. McAdoo. "When we applied Lidocaine to the surface of the spinal cord before conducting our surgery," Hulsebosch continued, "we found that those releases were completely blocked."