Opioids and analgesics use after adult spinal deformity surgery correlates with sagittal alignment and preoperative analgesic pattern

  • Anouar BourghliEmail author
  • Louis Boissiere
  • Daniel Larrieu
  • Farah Kaissar
  • Derek Cawley
  • Takashi Fujishiro
  • David Kieser
  • Olivier Gille
  • Jean-Marc Vital
  • Ahmet Alanay
  • Ferran Pellisé
  • Emre Acaroglu
  • Francisco-Javier Perez-Grueso
  • Franck Kleinstück
  • Ibrahim Obeid
  • European Spine Study Group
Original Article



To assess pain, health-related quality of life (HRQOL) scores and sagittal parameters of adult spinal deformity (ASD)-operated patients in the context of their analgesic consumption especially opioids (narcotics) over the first year postoperative period.


In total, 372 patients from a multicenter database were stratified into 3 groups at baseline: 241 patients in the minimal group (no analgesic, or NSAIDs/narcotics weekly or less), 64 in the NSAIDs every day group and 67 in the narcotics every day group. HRQOL and back and leg pain scores were evaluated at 6 months and 1 year postoperatively. Also several sagittal alignment parameters were assessed.


Significant improvements in pain and HRQOL scores were observed across all 3 groups by 1 year (P < 0.05) postoperatively. While the minimal group had the best pre- and postoperative HRQOL scores, the NSAID group demonstrated the best improvement in HRQOL. Only the minimal group displayed continued improvement from 6 months to 1 year. 90%, 65% and 40% of minimal, NSAID and narcotic groups of patients, respectively, no longer took any analgesics at 1 year postoperatively. Alternatively, 36% of patients in the narcotics group continued to take narcotics at 1 year. Residual malalignment increased NSAIDs consumption in different groups at 1 year.


This study evaluated the analgesics use after ASD surgery in relation to the clinical and radiological outcomes. Despite important postoperative opioids consumption in the narcotics group, clinical outcome yet improved. Malalignment parameters demonstrated a predictive value in regard to NSAIDs’ usage.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.


Opioids NSAID Adult spinal deformity Health-related quality of life scores Sagittal alignment 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2019_6141_MOESM1_ESM.pptx (184 kb)
Supplementary material 1 (PPTX 184 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Anouar Bourghli
    • 1
    Email author
  • Louis Boissiere
    • 2
  • Daniel Larrieu
    • 2
  • Farah Kaissar
    • 2
  • Derek Cawley
    • 2
  • Takashi Fujishiro
    • 2
  • David Kieser
    • 2
  • Olivier Gille
    • 2
  • Jean-Marc Vital
    • 2
  • Ahmet Alanay
    • 3
  • Ferran Pellisé
    • 4
  • Emre Acaroglu
    • 5
  • Francisco-Javier Perez-Grueso
    • 6
  • Franck Kleinstück
    • 7
  • Ibrahim Obeid
    • 2
  • European Spine Study Group
  1. 1.Orthopedic and Spinal Surgery DepartmentKingdom HospitalRiyadhSaudi Arabia
  2. 2.Orthopedic Spinal Surgery Unit 1Bordeaux Pellegrin HospitalBordeauxFrance
  3. 3.Spine Surgery UnitAcibadem Maslak HospitalIstanbulTurkey
  4. 4.Spine Surgery UnitHospital Universitario Val HebronBarcelonaSpain
  5. 5.Ankara Acibadem Spine CenterAnkaraTurkey
  6. 6.Spine Surgery UnitHospital Universitario La PazMadridSpain
  7. 7.Spine Center, Schulthess KlinikZurichSwitzerland

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