title: Prevention of Paralytic Ileus Utilizing Alvimopan Following Spine Surgery.
abstract: Postoperative ileus affects a substantial proportion of patients undergoing elective spine surgery, especially in cases of spinal deformity correction and where an anterior lumbar approach is utilized. Though the first line of treatment for postoperative ileus is conservative management, recent advances in pharmacology have yielded promising options for both treatment and prevention. We report a case of a patient who underwent a two-stage posterior spinal fusion. The patient suffered with a severe, prolonged ileus after her initial surgery. To prevent ileus following her second spinal surgery, alvimopan (a µ-opioid receptor antagonist) was administered and she had a rapid return of bowel function with no signs of ileus. Alvimopan, has been shown to reduce the rate of ileus in colorectal surgery patients, and may be useful for preventing ileus in high-risk orthopedic and spine surgery patients, although prospective studies will be needed to test this hypothesis.
authors.affiliation: Department of Orthopedic Surgery, Adult Spinal Deformity Service, Brown University Alpert Medical School , Rhode Island Hospital, Providence, RI, USA.
authors.forename: Kalpit N
authors.initials: KN
authors.lastname: Shah
authors.affiliation: Department of Orthopedic Surgery, Adult Spinal Deformity Service, Brown University Alpert Medical School , Rhode Island Hospital, Providence, RI, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Waryasz
authors.affiliation: Department of Orthopedic Surgery, Adult Spinal Deformity Service, Brown University Alpert Medical School , Rhode Island Hospital, Providence, RI, USA.
authors.forename: J Mason
authors.initials: JM
authors.lastname: DePasse
authors.affiliation: Department of Orthopedic Surgery, Adult Spinal Deformity Service, Brown University Alpert Medical School , Rhode Island Hospital, Providence, RI, USA.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Daniels
keywords: Spine surgery; ileus; post operative management