Prescription trends of opioid and non-opioid controlled prescription adjunctive analgesics prior to and after cervical spinal surgery: a retrospective cohort study.

Abstract

Cervical spine surgery (CSS) may be needed in those with refractory pain or neurologic deficits to improve outcomes in patients with cervical spine disease. However, consensus varies in the literature on the effect of surgery on opioid use. The objectives of this study were to analyze prescription rates of multiple controlled-substances before and after CSS and distinguish factors that may have contributed to opioid use after surgery. This is a retrospective cohort study analyzing prescription trends of various controlled substances in 632 patients who underwent CSS from 2019 to 2021. Opioids have the largest rise in prescriptions at 3- and 6-month time points after CSS. A significant association (p < 0.001) was found between opioid use one year prior to and one year after CSS. Exposure to opioids prior to surgery (OR 2.77, 95% CI 1.43, 5.51, p = 0.003) and higher morphine milligram equivalent (MME) dose (OR 1.02, 95% CI 1.01, 1.04, p = 0.012) were found to be associated to opioid use after surgery. Significantly more females were prescribed controlled substances (p = 0002). Higher MME dose and opioid exposure prior to surgery are important factors in predicting post-surgical opioid use.