Shah Rohan M, Saklecha Anjay, Patel Alpesh A, Divi Srikanth N
Northwestern University, Chicago, IL, USA.
Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Curr Rev Musculoskelet Med. 2022 Apr;15(2):133-142. doi: 10.1007/s12178-022-09743-w. Epub 2022 Feb 8.
Cannabis is among the most used illicit substances globally, with medical applications, increased legalization, and shifting social attitudes leading to increased use in recent years. Cannabinoids are a group of psychoactive substances found within the cannabis plant, with the most common being Δ-tetrahydrocannabinol and cannabidiol. Due to the high prevalence of use, it is increasingly important to evaluate the effects of cannabis and cannabinoids on spine patients, in both operative and nonoperative settings.
Cannabis and cannabinoids may be effective in treating patients with chronic conditions such as back pain and spinal cord injuries. Longitudinal effects and implications on surgical outcomes and complications are poorly understood. High-quality, outcomes-focused research can inform approaches for clinicians to approach cannabis and cannabinoid use. Studies to elucidate the standardization of cannabis regimens can help develop guidelines for potential therapeutic applications. Cannabis and cannabinoids may be useful alternatives or additions for many spine patients, but future research is needed for recommendations to be determined. Our manuscript reviews the available literature regarding cannabis use and various spinal conditions, organizing our findings into the following narrative themes: (1) the management of chronic lower back pain, (2) perioperative outcomes, (3) cannabis use in general orthopaedic procedures, and (4) spinal cord injuries.
大麻是全球使用最为广泛的非法物质之一,随着其医学应用、合法化程度提高以及社会态度转变,近年来其使用量不断增加。大麻素是在大麻植物中发现的一类精神活性物质,最常见的是Δ-四氢大麻酚和大麻二酚。鉴于大麻的高使用率,评估大麻和大麻素在手术和非手术环境下对脊柱疾病患者的影响变得越来越重要。
大麻和大麻素可能对治疗慢性疾病(如背痛和脊髓损伤)患者有效。其对手术结果和并发症的长期影响及意义尚不清楚。高质量、以结果为导向的研究可为临床医生使用大麻和大麻素提供指导。阐明大麻治疗方案标准化的研究有助于制定潜在治疗应用的指南。大麻和大麻素可能是许多脊柱疾病患者有用的替代或补充治疗方法,但需要进一步研究才能确定相关建议。我们的手稿回顾了有关大麻使用和各种脊柱疾病的现有文献,将研究结果归纳为以下几个主题:(1)慢性下背痛的管理,(2)围手术期结果,(3)大麻在一般骨科手术中的应用,以及(4)脊髓损伤。