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Opioid use prior to adult spinal deformity surgery increased odds of chronic opioid use

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Opioid use prior to adult spinal deformity surgery increased odds of chronic opioid use


August 02, 2022

1 min read


Source/Disclosures


Disclosures:
Neuman reports receiving grants or research support from DePuy Synthes and being on the speakers bureau for Medtronic.


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Patients who underwent adult spinal deformity surgery had higher odds of chronic opioid use if they used opioids preoperatively and had a duration of pain of 4 or more years, according to published results.

“Previous studies have shown that preoperative opioid use is a risk factor for chronic opioid use. This study reiterates this point for [patients with adult spinal deformity],” Brian J. Neuman, MD, told Healio. “This, however, is the first study to my knowledge that looks at duration of symptoms and the risk of chronic opioid use. This allows us to have this discussion with the patient.”



Opioids

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Neuman and colleagues retrospectively analyzed patient characteristics, duration of preoperative pain, radiculopathy, preoperative Scoliosis Research Society (SRS)-22r score, Oswestry Disability Index (ODI) value and surgical characteristics of 119 patients with adult spinal deformity who underwent arthrodesis of four or more spinal levels from January 2008 to February 2018 with 2-year follow-up. Researchers considered chronic opioid use, defined as opioid use at both 1 year and 2 years postoperatively, as the primary outcome variable.

Researchers found preoperative opioid use in 50% of patients and chronic opioid use in 29% of patients. Patients with preoperative opioid use and preoperative pain duration of 4 or more years had higher odds of chronic opioid use, according to results. Researchers noted no significant association between patient characteristics, surgical variables, ODI value and SRS-22r score with chronic postoperative opioid use.

“In general, this impacts orthopedics and other surgical specialties in that it identifies a risk factor we see in this patient population,” Neuman said. “Other specialties should assess if this exists in their patients; they may also identify a different duration that places these patients at risk. It is also crucial that by identifying these risk factors, we can then implement strategies and protocols to help these patients at risk wean safely off these medications.”