Early Opioid Consumption Patterns After Anterior Cervical Spine Surgery

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Limited data exists on opioid consumption following anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA).
• Understanding postoperative opioid use is crucial for developing appropriate post-discharge prescription guidelines.

Purpose of the Study:

• To prospectively record daily opioid use and pain levels in patients after 1-level or 2-level ACDF or CDA.
• To identify factors influencing opioid consumption and inform prescription practices.

Main Methods:

• A prospective observational study enrolled patients undergoing ACDF or CDA.
• Daily opioid use and pain scores were collected via automated text messaging.
• Opioid use was quantified in 5mg oxycodone equivalents; refill data were verified.

Main Results:

• Of 48 completers, 27.1% used no opioids post-discharge, and half of users ceased by postoperative day 8.
• Median post-discharge use was 6.7 pills; no significant difference between 1-level and 2-level procedures.
• Preoperative intermittent opioid use was linked to higher postoperative consumption.

Conclusions:

• Most patients require minimal opioids after ACDF or CDA.
• A standardized discharge prescription of 12 oxycodone 5mg pills, with patient education, is proposed.
• This approach aims to optimize pain management while minimizing excess opioid exposure.