Journal of craniovertebral junction & spine · 2025
Adult spinal deformity patients with spinal cord stimulators and intrathecal drug delivery devices do not have greater chronic opioid use after surgery.
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Dionne Alexandra C, Holuba Kurt, Sevensky Riley, Reyes Justin L, Miller Roy, Hassan Fthimnir M, Coury Josephine R, Lombardi Joseph M, Lenke Lawrence G, Sardar Zeeshan M
Аннотация
OBJECTIVE: The objective of the study was to determine if adult spinal deformity (ASD) patients with spinal cord stimulators (SCS) or intrathecal drug delivery devices (IDDD) have more chronic opioid consumption or worse surgical outcomes than a matched cohort.
METHODOLOGY: We conducted a retrospective matched comparison of implanted (SCS [n = 11] or IDDD [n = 3]) and nonimplanted ASD patients (n = 40) who underwent corrective spine surgery at a single center. We evaluated their intraoperative characteristics, long-term postoperative complications, radiographic correction, and chronic opioid use, measured as use on more than 50% of days for >6 months pre-or postoperative and total morphine mg equivalents (MME) and MME per dose.
RESULTS: We found no difference in the rate of chronic opioid use between the implanted and nonimplanted ASD cohort: 6 m preoperative: 50% (n = 7) versus 40% (n = 16), admission: 71% (10) versus 45% (18), 6 m postoperative: 64.3% (9) versus 32.5% (13), final follow-up (FFU): 64.3% (9) versus 37.5% (15), P > 0.05. Similarly, there was no difference in total MME: 6 m preoperative: 101.3 ± 177.8 versus 37.3 ± 89.4, admission: 68.2 ± 77.8 versus 45.3 ± 129.9, 6 m postoperative: 59.8 ± 83.1 versus 20.8 ± 46.9, FFU: 51.2 ± 68.7 versus 31.1 ± 55.5, P > 0.05 for all. Implanted patients had higher OR time (implanted: 734.9 [103.4] vs. nonimplanted: 637.2 [147.8] min, P = 0.0272), intraoperative blood requirement (2.1 [1.6] µ pRBCs vs. 1.1 [1.5] µ, P = 0.0500), and rate of dural tears (42.9% (6/14) vs. 15% (6/40).
CONCLUSION: This study indicates that implanted ASD patients are not at increased risk for chronic opioid use and do not have worse postoperative compilation rates than nonimplanted patients.
METHODOLOGY: We conducted a retrospective matched comparison of implanted (SCS [n = 11] or IDDD [n = 3]) and nonimplanted ASD patients (n = 40) who underwent corrective spine surgery at a single center. We evaluated their intraoperative characteristics, long-term postoperative complications, radiographic correction, and chronic opioid use, measured as use on more than 50% of days for >6 months pre-or postoperative and total morphine mg equivalents (MME) and MME per dose.
RESULTS: We found no difference in the rate of chronic opioid use between the implanted and nonimplanted ASD cohort: 6 m preoperative: 50% (n = 7) versus 40% (n = 16), admission: 71% (10) versus 45% (18), 6 m postoperative: 64.3% (9) versus 32.5% (13), final follow-up (FFU): 64.3% (9) versus 37.5% (15), P > 0.05. Similarly, there was no difference in total MME: 6 m preoperative: 101.3 ± 177.8 versus 37.3 ± 89.4, admission: 68.2 ± 77.8 versus 45.3 ± 129.9, 6 m postoperative: 59.8 ± 83.1 versus 20.8 ± 46.9, FFU: 51.2 ± 68.7 versus 31.1 ± 55.5, P > 0.05 for all. Implanted patients had higher OR time (implanted: 734.9 [103.4] vs. nonimplanted: 637.2 [147.8] min, P = 0.0272), intraoperative blood requirement (2.1 [1.6] µ pRBCs vs. 1.1 [1.5] µ, P = 0.0500), and rate of dural tears (42.9% (6/14) vs. 15% (6/40).
CONCLUSION: This study indicates that implanted ASD patients are not at increased risk for chronic opioid use and do not have worse postoperative compilation rates than nonimplanted patients.