Risk Factors For Prolonged Opioid Use After Spine Surgery

Area of Science:

• Orthopedics
• Pain Management
• Health Services Research

Background:

• Opioid use after spine surgery is a significant concern.
• Factors influencing prolonged post-operative opioid use require further investigation.
• Pre-operative opioid use may be linked to increased post-operative complications.

Purpose of the Study:

• To identify factors associated with prolonged post-operative opioid use following spine surgery.
• To assess the risk of post-operative complications linked to pre-operative opioid use.

Main Methods:

• Retrospective review of the MarketScan database (2005-2014).
• Inclusion of patients undergoing cervical and lumbar spine surgery.
• Analysis of pre-operative comorbidities and opioid utilization (1-3 months prior).
• Use of regression analysis to determine risk factors for prolonged post-operative opioid use.

Main Results:

• 34.9% of spine surgery patients used opioids pre-operatively.
• Pre-operative opioid use was strongly associated with prolonged post-operative opioid use at all measured intervals.
• Mental health diagnosis, tobacco use, chronic pain/CRPS, and neuromodulatory medications increased the likelihood of prolonged post-operative opioid use.

Conclusions:

• Pre-operative opioid use and specific comorbidities are key predictors of prolonged post-operative opioid consumption.
• Chronic opioid use, chronic pain diagnosis, or use of neuromodulatory medications present the highest risk.
• Pre-operative opioid users faced higher readmission rates and serious complications, informing analgesic strategies and health system planning.