Evolution of somatosensory processing signs after nociceptive targeted surgery in patients with musculoskeletal disorders: a systematic review

Sophie Vervullens, Lotte Meert, Mira Meeus*, Isabel Baert, Christiaan H. W. Heusdens, Cleo Caethoven, Nina Charpentier, Amber Vervliet, Rob J. E. M. Smeets

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

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Abstract

Surgery is often advised when conservative treatment fails in musculoskeletal pain conditions, but a substantial proportion still suffers chronic pain after surgery. Somatosensory processing system (SPS) signs were previously studied as potential predictors for chronic postsurgical pain, but results are inconsistent. Therefore, studying the evolution of SPS signs could be of added value. The aim was to summarize all studies that measured how SPS signs evolved after nociceptive targeted surgery in musculoskeletal disorders and to find preoperative, perioperative, and postoperative predictors for the evolution of these SPS signs. Data were summarized, and risk of bias and level of evidence and recommendation were determined. Twenty-one studies were included. Five scored a low, 3 a moderate, and 13 a high risk of bias. In general, no consistent evolution of SPS signs comparing preoperative and postoperative values and predictors for this evolution in musculoskeletal disorders could be found. In most cases, static quantitative sensory testing (QST) did not change or conflicting results were found. On the other hand, dynamic QST mostly improved after surgery. Worthfully mentioning is that worsening of SPS signs was only seen at a follow-up of <3 months after surgery, that conclusions are stronger when evaluating dynamic QST with a follow-up of ≥3 months after surgery, and that pain improvement postsurgery was an important predictor. Future high-quality research should focus on the evolution of SPS signs after nociceptive targeted surgery, accounting for pain improvement groups and focusing on preoperative, perioperative, and postoperative predictors of this evolution.

Original languageEnglish
Pages (from-to)1428-1450
Number of pages23
JournalPain
Volume164
Issue number7
DOIs
Publication statusPublished - 1 Jul 2023

Keywords

  • Somatosensory processing signs
  • Musculoskeletal disorders
  • Musculoskeletal surgery
  • Central pain mechanisms
  • CHRONIC POSTOPERATIVE PAIN
  • TOTAL KNEE ARTHROPLASTY
  • TOTAL HIP
  • CENTRAL SENSITIZATION
  • TEMPORAL SUMMATION
  • PREDICTIVE-VALUE
  • SURGICAL PAIN
  • OSTEOARTHRITIS
  • NORMALIZATION
  • REPLACEMENT

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