Patients facing lumbar fusion surgery who have been taking gabapentin or pregabalin long-term can proceed with confidence that their chronic medication use appears unlikely to compromise surgical success or recovery outcomes. This finding challenges growing concerns about gabapentinoids potentially interfering with bone healing processes during spinal fusion procedures.
The Pennsylvania-based study tracked 461 adult patients undergoing one or two-level lumbar fusion between 2017 and 2022, finding that 108 patients (23.4%) were chronically prescribed gabapentinoids before surgery—47 taking pregabalin and 61 taking gabapentin. Despite laboratory research suggesting these medications might impair bone metabolism, the clinical reality proved different. Two-year revision rates, surgical complications, and patient-reported pain and function scores showed no meaningful differences between chronic gabapentinoid users and non-users across all measured parameters.
This represents crucial real-world evidence contradicting laboratory-based concerns about gabapentinoid interference with spinal fusion healing. While previous research suggested these neuropathic pain medications might compromise bone formation, the clinical outcomes data provides reassurance for the substantial population of chronic pain patients who depend on gabapentinoids for symptom management. The study's strength lies in its comprehensive approach, utilizing prescription monitoring databases to verify actual medication use rather than relying on patient recall. However, the retrospective design and single-center nature limit broader generalizability, and longer follow-up periods might reveal delayed effects not captured in the two-year timeframe.