Neurosurgery · 2025
Risk Factors of Long-Term Opioid Use After Elective Cervical and Lumbar Spine Surgery: A Michigan Spine Surgery Improvement Collaborative Study.
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Kim Enoch, Kagithala Dheeraj, Hu Jianhui, Jarabek Kari, Brennan Matthew, Chaker Anisse N, Pawloski Jacob, Telemi Edvin, Mansour Tarek, Robles Maria Cielito, Fadel Hassan A, Springer Kylie, Schultz Lonni, Nerenz David R, Khalil Jad G, Easton Richard, Perez-Cruet Miguelangelo, Aleem Ilyas, Park Paul, Soo Teck, Tong Doris, Abdulhak Muwaffak, Schwalb Jason M, Chang Victor
Аннотация
BACKGROUND AND OBJECTIVES: Given the current opioid epidemic and its impact on public health, long-term opioid use after elective spine surgery is a significant concern. Identifying risk factors of long-term opioid use after spine surgery is crucial for developing effective interventions to reduce opioid dependence in this patient population. The objective of this study was to identify risk factors associated with long-term opioid use after elective lumbar and cervical spine surgeries.
METHODS: A retrospective analysis of patient data was conducted using the Michigan Spine Surgery Improvement Collaborative data registry. Patients who underwent elective lumbar or cervical spine surgery between March 2018 and September 2021 were included. Poisson generalized estimating equation models were used for multivariate analyses.
RESULTS: A total of 5301 and 3992 lumbar surgery patients at 1 and 2 years, respectively, and a total of 2074 and 1451 cervical surgery patients at 1 and 2 years, respectively, were included for analysis. Preoperative opioid use, opioid use at 90 days postoperatively, and poor functional status were the strongest predictors of long-term opioid use. Among all patients, preoperative opioid use most strongly predicted long-term use at 1 and 2 years for lumbar and cervical patients. Among opioid-naïve patients (preoperative nonusers), opioid use at 90 days postoperatively strongly predicted continued use at 1 and 2 years in both lumbar and cervical patients. The inability to achieve a minimal clinically important difference in Patient-Reported Outcomes Measurement Information System physical function was also associated with opioid use at 1-year and 2-year follow-up in lumbar and cervical patients.
CONCLUSION: Preoperative opioid use, opioid use at 90 days postoperatively, and failure to reach minimal clinically important difference of Patient-Reported Outcomes Measurement Information System Physical Function were the strongest predictors of long-term opioid use after elective lumbar and cervical spine surgeries.
METHODS: A retrospective analysis of patient data was conducted using the Michigan Spine Surgery Improvement Collaborative data registry. Patients who underwent elective lumbar or cervical spine surgery between March 2018 and September 2021 were included. Poisson generalized estimating equation models were used for multivariate analyses.
RESULTS: A total of 5301 and 3992 lumbar surgery patients at 1 and 2 years, respectively, and a total of 2074 and 1451 cervical surgery patients at 1 and 2 years, respectively, were included for analysis. Preoperative opioid use, opioid use at 90 days postoperatively, and poor functional status were the strongest predictors of long-term opioid use. Among all patients, preoperative opioid use most strongly predicted long-term use at 1 and 2 years for lumbar and cervical patients. Among opioid-naïve patients (preoperative nonusers), opioid use at 90 days postoperatively strongly predicted continued use at 1 and 2 years in both lumbar and cervical patients. The inability to achieve a minimal clinically important difference in Patient-Reported Outcomes Measurement Information System physical function was also associated with opioid use at 1-year and 2-year follow-up in lumbar and cervical patients.
CONCLUSION: Preoperative opioid use, opioid use at 90 days postoperatively, and failure to reach minimal clinically important difference of Patient-Reported Outcomes Measurement Information System Physical Function were the strongest predictors of long-term opioid use after elective lumbar and cervical spine surgeries.