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

Abstract

ObjectivePostoperative 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.MethodsDC 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. ResultsIn the postanesthesia care unit, the mean VAS back pain score was 5.87 ± 0.9 in the DC group and 6.95±1.0 (p=0.001) in the control group. The corresponding mean VAS scores for the DC vs. control groups were 3.8±1.1 vs. 5.4±0.7 (p < 0.001) at 6 hours postoperatively, and 2.7±0.7 vs. 6.25±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±562.7 mg vs. 4,633.3±693.5 mg (p<0.005), 53.3±19.5 mg vs. 85.3±33.4 mg (p<0.005), and 63.3±83.4 mg vs. 393.3±79.9 mg (p<0.0001), respectively. ConclusionThe 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.

Cold for centuries: a brief history of cryotherapies to improve health, injury and post-exercise recovery

“…became popular after receiving patents in the 1990s and early 2000s. Initially implemented for recovery following surgical procedures, such as knee arthroplasty (Su et al 2012 ; Murgier et al 2017 ; Schinsky et al 2016 ), knee arthroscopy (Waterman et al 2012 ; Murgier and Cassard 2014 ), hip arthroplasty (Leegwater et al 2012 ), hip arthroscopy (Klaber et al 2019 ), and spine surgery (Nabıyev et al 2018 ; Bellon et al 2019 ), these devices deliver continuous or intermittent compression whilst simultaneously supplying low temperature “exchange fluid” to the injured area. Importantly, they can be applied for as long a time period as desired without substantial change in the temperature of the material contacting the affected area.…”

Effect of applying cold gel pack on reduction of postoperative pain in cesarean section, low midline skin incision: A randomized controlled trial

“…There are many theories explaining the mechanisms of cold‐reducing pain mainly involving pro‐inflammatory cytokines suppression and delaying conduction velocity of peripheral nerves. It is proved to be effective in gynecologic surgery, 8,10–12 maxillofacial surgery, 13–14 orthopedic surgery, 15–17 general surgery, 3,18–21 and open heart surgery 22 …”

Ice therapy: cool, current and complicated

“…The authors attributed this to oedema reduction, reduced metabolic rate and inflammatory response, modification of endogenous analgesic systems and inhibition of the neuromuscular system (reducing muscle spasticity, nerve conduction velocity and muscle strength) (Nabiyev et al . ). (There are further references and examples in Table .)…”