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Updated: Aug 6, 2026
05:30
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
NSAID Use Is Associated With Increased Postoperative Complications, but Mortality Benefit, Following Spinal Fusion
James M Rizkalla1,2, Joseph A Weiner1,3, Brook I Martin1
1Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
Clinical Spine Surgery
|July 20, 2026
Summary
Nonsteroidal anti-inflammatory drugs (NSAIDs) use after spinal fusion surgery was linked to lower mortality but increased complications like pseudoarthrosis and readmissions. Further research is needed to understand NSAID effects in spinal fusion patients.
Area of Science:
- Spine surgery outcomes
- Pharmacological interventions in orthopedics
- Patient safety in surgical procedures
Background:
- Effective postoperative pain management after spine surgery is crucial, often involving narcotics.
- Opioid-related complications negatively impact patient outcomes and increase healthcare costs.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are explored as alternatives to minimize opioid use, but evidence on their effect on spinal fusion is limited and conflicting.
Purpose of the Study:
- To investigate the association between perioperative nonsteroidal anti-inflammatory drug (NSAID) use and mortality.
- To evaluate the relationship between NSAID use and complications, including pseudoarthrosis, following spinal fusion surgery.
- To analyze the impact of NSAIDs on 1-year readmission rates in patients undergoing spinal fusion.
Main Methods:
- Retrospective cohort study utilizing data from the Centers for Medicare and Medicaid Services (CMS).
- Inclusion of patients aged 65+ who underwent spinal fusion between 2016-2021 and had Part D (pharmacy) benefits.
- Comparison of two cohorts: no NSAIDs (n=169,712) versus NSAID users (n=130,029) based on prescription claims within 90 days pre- to 1-year post-surgery.
Main Results:
- NSAID users were younger with lower Hierarchical Conditions Classification (HCC) scores.
- Perioperative NSAID use was associated with a statistically significant reduction in 1-year mortality.
- NSAID use correlated with significantly higher rates of 1-year readmissions, pseudoarthrosis, and overall complications.
Conclusions:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with increased overall complication rates in patients undergoing spinal fusion.
- The findings suggest a complex relationship between NSAID use and outcomes after spinal fusion.
- Further investigation is warranted to fully elucidate the effects of NSAIDs in the context of spinal fusion surgery.
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