Refractory Neuropathic Pain With Escalating Opioid Requirements and Ketamine Use in Advanced Degenerative Spine Disease: A Hospice Case Report

Gokhan Demir, Sneha Akurati, Angel Sanchez Artiles, Malika Rahaman, Tracy Romanello, Division of Palliative and Hospice Medicine, HCA Florida Aventura Hospital, University of Miami Leonard M. Miller School of Medicine, Catholic Hospice, Catholic Health Services

American Journal of Hospice and Palliative Medicine®

Published online on April 22, 2026

Abstract

American Journal of Hospice and Palliative Medicine®, Ahead of Print.
BackgroundHospice patients with advanced degenerative spine disease frequently experience refractory neuropathic pain complicated by opioid tolerance, central sensitization, and functional decline.Case PresentationA 63-year-old male with stage III ...