Lumbar Spine Surgeries and Medication Usage During Hospital Stay: One-Center Perspective.

Abstract

Background: Pain after spine surgery is usually managed with opioid and nonopioids. The rate of lumbar spine surgeries (LSS) is rising, but current practices on LSS are not known. A current trend in LSS and medication usage by age group is needed to gain a better understanding of how LSS and its pain management vary by age. Objective: The aim of this study was to report current practices of LSS of discectomy, laminectomy, and fusion in patients aged 18 and older and to gain an understanding of medication use for management of LSS. Methods: This retrospective study analyzed data of the University of Kansas Medical Center from 2007 to 2014 of patients (>18 years of age) undergoing laminectomy, discectomy, and fusion. Results: A total of 19 463 patients underwent LSS between 2007 and 2014 at Kansas University hospital. For the purpose of this study, 3115 patients' medical records were observed. A 50% increase in LSS between 2007 and 2014 was noted. Specifically, more than 2-fold increase in LSS was observed in patients aged 65 years and older. Among those aged 65 years and older, laminectomy was the most commonly performed surgery (69.6%) while discectomy was the most common surgery performed among those aged 18 to 34 (82.9%) and those aged 35 to 44 (72%). The medication use also increased with a highest usage in opioids alone (55%), followed by opioids combined with other analgesics (42.7%), regardless of lumbar surgery type or age. Conclusion: The information of increase in both LSS and the medication usage over the 7 years can be used to gain a better understanding of quality, expenditure, and outcomes following LSS. This knowledge may help health care providers plan patient care and rehabilitation services for older adults, as the trajectory of lumbar spine surgery is likely to rise with growing prevalence of older adults. The information regarding increased opioid utilization may also help clinicians to refine opioid usage and consider alternative approaches to manage acute postoperative pain, in light of the current concerns related to overutilization of opioids.