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Preoperative duration of pain is associated with chronic opioid use after adult spinal deformity surgery

Abstract

Purpose

Few studies have explored the association between preoperative patient-reported measures and chronic opioid use following adult spinal deformity (ASD) surgery. We sought to explore the association between preoperative duration of pain, as well as other patient-reported factors, and chronic opioid use after ASD surgery.

Methods

We retrospectively reviewed our U.S. academic tertiary care hospital’s database of ASD patients. We included patients 18 years or older who underwent arthrodesis of four or more spinal levels from January 2008 to February 2018, with 2-year follow-up. The primary outcome variable was chronic opioid use, defined as opioid use at both 1 and 2 years postoperatively. We analyzed patient characteristics; duration of preoperative pain (<4 years or ≥4 years); radiculopathy; preoperative Scoliosis Research Society-22r (SRS-22r) score; Oswestry Disability Index (ODI) value; and surgical characteristics.

Results

Of 119 patients who met the inclusion criteria, 93 (78%) were women, and mean ± standard deviation age was 59 ± 13. Sixty patients (50%) reported preoperative opioid use, and 35 (29%) reported chronic opioid use. Preoperative opioid use was associated with higher odds of chronic use (adjusted odds ratio, 5.9; 95% confidence interval 1.6–21), as was preoperative pain duration of ≥4 years (adjusted odds ratio, 3.3; 95% confidence interval 1.1–9.8). Patient characteristics, surgical variables, ODI value, and SRS-22r score were not significantly associated with chronic postoperative opioid use.

Conclusion

Preoperative opioid use and duration of pain of ≥4 years were associated with higher odds of chronic opioid use after ASD surgery.

Level of Evidence

III.

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Availability of data

Data are available upon request.

Code availability

N/A.

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Funding

No funding was received in support of this study.

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Authors and Affiliations

Authors

Contributions

Kevin C. Mo—Writing/editing of manuscript, final review/approval/revision of the manuscript, and data analysis. Rahul Sachdev—Conception/design, data analysis, writing/editing of manuscript, and final review/approval of the manuscript. Bo Zhang—Writing/editing of manuscript, and final review/approval of the manuscript. Amar Vadhera—Data analysis, writing/editing of manuscript, and final review/approval of the manuscript. Mark Ren—Conception/design, writing/editing of manuscript, and final review/approval of the manuscript. Nicholas S. Andrade—Data analysis, writing/editing of manuscript, and final review/approval of the manuscript. Khaled M. Kebaish—Writing/editing of manuscript, and final review/approval of the manuscript. Richard L. Skolasky—Writing/editing of manuscript, and final review/approval of the manuscript. Brian J. Neuman—Conception/design, writing/editing of manuscript, and final review/approval of the manuscript.

Corresponding author

Correspondence to Brian J. Neuman.

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Conflict of interest

Dr. Kebaish reports consultant fees and other support from DePuy Synthes and K2M, as well as support from Orthofix and SpineCraft. Dr. Neuman reports grants/research support from DePuy Synthes and is on the speaker’s bureau for Medtronic. All the other authors report no conflicts of interest concerning the materials or methods used in this study or the findings specified in this paper.

Ethics approval

The study received approval from our institutional review board. IRB committee: IRB-X, IRB number: IRB00135145.

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Mo, K.C., Sachdev, R., Zhang, B. et al. Preoperative duration of pain is associated with chronic opioid use after adult spinal deformity surgery. Spine Deform (2022). https://doi.org/10.1007/s43390-022-00531-7

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  • DOI: https://doi.org/10.1007/s43390-022-00531-7

Keywords

  • Adult spinal deformity
  • Chronic opioid use
  • Clinical presentation
  • Duration of symptoms
  • Pain
  • Preoperative opioid use