Predictors of Long-term Opioid Use Following Lumbar Fusion Surgery

Area of Science:

• Orthopedic Surgery
• Pain Management
• Public Health

Background:

• Opioid prescriptions for low back pain have surged.
• Long-term opioid use post-lumbar fusion lacks comprehensive risk factor analysis in large national studies.

Purpose of the Study:

• To identify risk factors for long-term opioid use following lumbar spinal fusion.
• To analyze these factors in a nationally representative cohort of commercially insured adults.

Main Methods:

• Retrospective cohort study of 8377 adults undergoing lumbar fusion (2009-2012).
• Defined long-term opioid use as ≥365 days of filled prescriptions within 24 months post-surgery.
• Used multivariable logistic regression to determine adjusted odds ratios (ORs).

Main Results:

• Pre-surgery opioid duration, revision surgery, and depression diagnosis were associated with increased long-term opioid use.
• Anterior fusion was linked to a decreased risk of long-term opioid use.
• Significant ORs were reported for pre-surgery opioid use quartiles, refusion, and depression.

Conclusions:

• Findings offer valuable insights for physicians and patients regarding opioid dependence risks after lumbar fusion.
• Highlights the importance of pre-operative opioid use assessment and patient history in managing post-surgical pain.