Bone and Joint Institute
Document Type
Article
Publication Date
1-1-2020
Journal
Canadian Journal of Surgery
Volume
63
Issue
3
First Page
E306
Last Page
E312
URL with Digital Object Identifier
10.1503/CJS.018218
Abstract
© 2020 Joule Inc. or its licensors Background: Opioid use in North America has increased rapidly in recent years. Preoperative opioid use is associated with several negative outcomes. Our objectives were to assess patterns of opioid use over time in Canadian patients who undergo spine surgery and to determine the effect of spine surgery on 1year postoperative opioid use. Methods: A retrospective analysis was performed on prospectively collected data from the Canadian Spine Outcomes and Research Network for patients undergoing elective thoracic and lumbar surgery. Selfreported opioid use at baseline, before surgery and at 1 year after surgery was compared. Baseline opioid use was compared by age, sex, radiologic diagnosis and presenting complaint. All patients meeting eligibility criteria from 2008 to 2017 were included. Results: A total of 3134 patients provided baseline opioid use data. No significant change in the proportion of patients taking daily (range 32.3%–38.2%) or intermittent (range 13.7%–22.5%) opioids was found from pre2014 to 2017. Among patients who waited more than 6 weeks for surgery, the frequency of opioid use did not differ significantly between the baseline and preoperative time points. Significantly more patients using opioids had a chief complaint of back pain or radiculopathy than neurogenic claudication (p < 0.001), and significantly more were under 65 years of age than aged 65 years or older (p < 0.001). Approximately 41% of patients on daily opioids at baseline remained so at 1 year after surgery. Conclusion: These data suggest that additional opioid reduction strategies are needed in the population of patients undergoing elective thoracic and lumbar spine surgery. Spine surgeons can be involved in identifying patients taking opioids preoperatively, emphasizing the risks of continued opioid use and referring patients to appropriate evidencebased treatment programs.
Notes
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This article was originally published as:
Stratton, A. et al. (2020). Title: Opioid use trends in patients undergoing elective thoracic and lumbar spine surgery. Canadian Journal of Surgery, 63(3): E306-E312. DOI : 10.1503/CJS.018218