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Opioids and Spinal Surgery

Preoperative Opioid Use Heightens Risk for Spinal Deformity Surgeries

Findings from a recent study conducted by researchers from Johns Hopkins University School of Medicine adds to evidence reported last month in the Daily Dose on the risks of preoperative opioid therapy for patients undergoing spinal surgery. This multicenter database study of adult patients who underwent surgery for adult spinal deformity (ASD) found that daily preoperative use was associated with more severe postoperative disability and longer intensive care duration. Senior author Michael Raad, MD, research fellow in orthopaedic surgery at Johns Hopkins, commented, “We’re not suggesting that people facing ASD surgery stop taking opioids on the basis of this study, but we do think it’s worthwhile having more conversations with physicians to see if there are alternatives or ways of reducing opioid use before surgery.” The findings were published in the journal Spine.

ASD is a disorder that includes most forms of adult scoliosis, and up to 70% of sufferers have used opioids for management of their pain. The Johns Hopkins team assessed records from 475 patients in 18 surgical centers who had surgery for their ASD between 2008 and 2015. Average patient age was 58 years and 79% were women. 44% of the study group self-reported daily use of opioid medications prior to their surgery. This cohort averaged 16 hours longer stay in intensive care, and a 70% higher incidence of prolonged hospital stay overall. They were also at 690% more likely to be taking daily opioids at 2 years postprocedure. Lead author Khaled Kebaish, MF, FRCSC, summarized, “We hope that this information serves as a foundation for future research into the prevalence of daily narcotic use in this patient group and provides clinicians with a framework for patient risk stratification and preoperative counseling.”

Read more about the study findings.

The journal abstract may be read here.

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