84. Incidence and predictors of long-term opioid use following cervical spine fusion surgery

Abstract

BACKGROUND CONTEXT Over the past 10 years, opioid expenditures for spine-related pain increased dramatically in USA. Orthopedic surgery has been reported as the third highest opioid-prescribing specialty, in patients older than 40 years old. PURPOSE The aim of this study was to determine the incidence of opioid use (OU) following cervical spine fusion surgery, and to identify the predictors of prolonged opioid use at 3 months, 6 months and 12 months following surgery. STUDY DESIGN/SETTING A retrospective cohort study at University of Missouri hospitals. PATIENT SAMPLE All patients who underwent cervical arthrodesis for degenerative cervical spine disease over 7 years, between 2010 and 2016, who had at least one year of postoperative follow up at the University of Missouri hospitals. OUTCOME MEASURES Incidence of pre- and postoperative opioid prescriptions and predictors of long-term postoperative opioid use. METHODS Patients’ medical records were examined to collect data on the following: patient's characteristics (age, sex, race, monthly income, occupation, BMI, smoking behavior, comorbidities) associated pain measures (pre/postoperative VAS), ASA score, and pre/postoperative OU. Logistic regression analyses were applied to identify the predictors of prolonged OU at intervals following surgery. Significance was considered at p RESULTS Opioid use was shown in 46.9% of patients before operation, of whom 68.1%, 60.9%, and 50.7% remained on OU at 3, 6 and 12 months following surgery. Incidences of postoperative OU were 50%, 42.5% and 30.2% at 3, 6 and 12 months. Preoperative use was significantly associated with postoperative use at 3 months (X 2 =18.2, p CONCLUSIONS Perioperative opioid prescription for patients with cervical spine fusion is quite common. Minimizing preoperative opioid use should be investigated as a way to mitigate long–term OU. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.