Ketorolac is contraindicated in scoliosis surgery primarily because of its effect on...

Ketorolac is contraindicated in scoliosis surgery primarily because of its effect on...

• A. Renal effects
• B. Risk of postoperative hemorrhage
• C. Effects on bone healing
• D. Effects on pulmonary function

Answer: (C)

In scoliosis surgery that aims to fuse the vertebrae, solid bone healing and true fusion are essential for long-term stability. Ketorolac is a nonsteroidal anti-inflammatory drug that inhibits cyclooxygenase and reduces prostaglandin synthesis. Prostaglandins, especially PGE2, play a role in bone repair by promoting osteoblast activity and the remodeling needed to form a solid fusion. By blocking prostaglandin production, ketorolac can slow or impair bone healing, increasing the risk of nonunion in the fused segments. That’s why it is avoided in spinal fusion procedures like scoliosis surgery. Other concerns with NSAIDs, such as renal effects or a tendency to increase bleeding risk, exist but are not the primary reason in this setting; the critical issue is the potential interference with bone healing and fusion. Pulmonary function is not the central concern here.

In scoliosis surgery that aims to fuse the vertebrae, solid bone healing and true fusion are essential for long-term stability. Ketorolac is a nonsteroidal anti-inflammatory drug that inhibits cyclooxygenase and reduces prostaglandin synthesis. Prostaglandins, especially PGE2, play a role in bone repair by promoting osteoblast activity and the remodeling needed to form a solid fusion. By blocking prostaglandin production, ketorolac can slow or impair bone healing, increasing the risk of nonunion in the fused segments. That’s why it is avoided in spinal fusion procedures like scoliosis surgery.

Other concerns with NSAIDs, such as renal effects or a tendency to increase bleeding risk, exist but are not the primary reason in this setting; the critical issue is the potential interference with bone healing and fusion. Pulmonary function is not the central concern here.