A Review of Cannabinoids for Spine Surgery Pain Found Potential Promise but Very Few Studies and Major Knowledge Gaps

THC and CBD interact with endocannabinoid receptors in the CNS and immune system, potentially offering pain relief. The entourage effect may enhance therapeutic impact. Few studies have analyzed cannabinoid use in spine surgery, with variable results on reoperation rates, mortality, complications, postoperative opioid use, and length of stay. Major knowledge gaps exist in dosing, timing, route, and specific outcomes.

Qualitative review of existing literature on cannabinoids in spine surgery pain management, covering mechanisms, clinical evidence, safety, and ethical considerations.

Spine surgery is among the most painful surgical procedures, and opioid alternatives are urgently needed. However, the evidence base for cannabinoids in this setting is so thin that clinical recommendations are premature.

The gap between mechanistic promise and clinical evidence is stark. While there are biological reasons to think cannabinoids could help with spine surgery pain, the field needs to move from theoretical potential to actual clinical trials.

Very limited evidence base. No meta-analysis possible. Variable results across the few existing studies. Safety concerns (cognitive effects, cardiovascular risks, dependence potential) not well characterized in surgical populations.