Neck Pain, Preoperative Opioids, and Functionality After Cervical Fusion.

Area of Science:

• Orthopedic Surgery
• Pain Management
• Occupational Health

Background:

• Workers' compensation claims involve substantial costs, particularly for spinal surgery patients.
• Opioid use in this population is a significant concern impacting recovery and return-to-work.
• Cervical fusion for degenerative disk disease is a common procedure with varying return-to-work outcomes.

Purpose of the Study:

• To compare return-to-work (RTW) rates after single-level cervical fusion for degenerative disk disease.
• To evaluate the impact of preoperative opioid use on RTW in workers' compensation patients.
• To identify predictors of successful return to work after cervical fusion.

Main Methods:

• Retrospective cohort study of 281 workers' compensation patients undergoing single-level cervical fusion.
• Comparison between patients with preoperative opioid use (n=77) and those without (n=204).
• Primary outcome: meeting RTW criteria within 3 years post-surgery. Secondary outcomes included work absence duration and surgical details.

Main Results:

• Only 36.4% of opioid users met RTW criteria versus 56.4% of non-users.
• Opioid users were less likely to return to work (OR, 0.44; P=.0028).
• Opioid users had significantly longer work absence (255 more days, P=.0001).

Conclusions:

• Preoperative opioid use is a negative predictor of successful return to work after cervical fusion in workers' compensation patients.
• Opioid management for diskogenic neck pain may impede functional recovery and return to employment.
• This finding highlights the need to address opioid use in pre-surgical planning for spinal fusion.