Abstract
Purpose
The aim of this study was to identify factors associated with the outpatient narcotic intake of patients following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) and to introduce a safe and effective method of disposing of unused narcotics.
Methods
Following Institutional Review Board approval, retrospective review of prospectively collected data from patients undergoing PSF for AIS took place. Pain scores, narcotic use, patient demographic data, pre-, intra-, and postoperative parameters, and discharge data were gathered via chart review. Patients were divided into two groups according to home narcotic use, high use (top 25th percentiles) and low use (bottom 75th percentiles), and multivariate statistical analysis was conducted. Narcotic surplus was collected during postoperative clinic visits and disposed of using biodegradable bags.
Results
Statistical analysis of 27 patients included in the study showed that patients with a higher home narcotic use correlated with increased length of hospitalization with an average of 3.4 days compared to the lower-use group of 2.8 day (p = 0.03). Higher-use group also showed increased inpatient morphine milligram equivalent than the lower-use group. There was no significant difference of home narcotic use when looking at patient age, height, weight, BMI, levels fused, intraoperative blood loss, or length of surgery. A total of 502 narcotic doses were disposed of in the clinic.
Conclusion
Our study suggests that there are not a significant number of patient- or surgical-level factors predisposing patients to increased home narcotic usage following spinal fusion for adolescent idiopathic scoliosis.
Level of evidence
Level I, prospective study.
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Data availability
The data from this manuscript is available upon request.
Change history
02 March 2023
A Correction to this paper has been published: https://doi.org/10.1007/s43390-023-00673-2
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Funding was received from a QSVI grant from the Pediatric Orthopaedic Society of North America.
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J.G.M: acquisition of data; drafted the work; approved the version to be published; agree to be accountable for all aspects of the work. C.E.: acquisition of data; drafted the work; approved the version to be published; agree to be accountable for all aspects of the work. W.D.: analysis of data; drafted the work; approved the version to be published; agree to be accountable for all aspects of the work. A.E.: interpretation of data; critically revised the work; approved the version to be published; agree to be accountable for all aspects of the work. D.T.: substantial contributions to conception of the work; critically revised the work; approved the version to be published; agree to be accountable for all aspects of the work.
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Dr. Tuason wishes to disclose the following conflicts of interest: DePuy, A Johnson & Johnson Company: Paid consultant; Paid presenter or speaker. Globus Medical: Paid presenter or speaker. OrthoPediatrics: Paid consultant; Paid presenter or speaker. Pediatric Orthopaedic Society of North America: Board or committee member. Scoliosis Research Society: Board or committee member.
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The original online version of this article was revised: Dr. Tuason wishes to disclose the following conflicts of interest: DePuy, A Johnson & Johnson Company: Paid consultant; Paid presenter or speaker. Globus Medical: Paid presenter or speaker. OrthoPediatrics: Paid consultant; Paid presenter or speaker. Pediatric Orthopaedic Society of North America: Board or committee member. Scoliosis Research Society: Board or committee member. Additionally, funding was received from a QSVI grant from the Pediatric Orthopaedic Society of North America.
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Garcia-Muñoz, J., Elblein, C., David, W.B. et al. Prospective analysis of home narcotic consumption and management of excess narcotic prescription following adolescent idiopathic scoliosis surgery. Spine Deform 11, 651–656 (2023). https://doi.org/10.1007/s43390-022-00637-y
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DOI: https://doi.org/10.1007/s43390-022-00637-y