Home E-Weekly March 27, 2018

Opioids Increase Likelihood of Repeat Spinal Fusion Surgery

Published: March 27, 2018

BAck Pain MORE PAIN Patients using opioids long-term were 80% more likely to be hospitalized for back pain 90 days after surgery.

Patients taking opioids for back pain before their spinal fusion surgery are more likely to need repeat surgery, a study finds.

Almost one-fourth of patients analyzed were prescribed opioids for more than 6 months before their surgery, researchers at the Ohio State University Wexner Medical Center found. More than 90% of them were prescribed hydrocodone/acetaminophen, oxycodone/acetaminophen and oxycodone hydrochloride to manage their back pain.

These patients had a 19% higher risk of surgical wound complications within 90 days of surgery. They were also 31% more likely to visit the ER and 80% more likely be hospitalized for lumbar spine pain in this time frame. Long-term opioid use increased the likelihood a patient would need repeat spinal fusion surgery within a year by 33%.

"All of these findings highlight the vicious cycle of unrelieved pain and fusion and increased healthcare costs in long-term opioid users," the researchers stated in the study published in the journal Spine.

"With increasing emphasis on cost containment and quality improvement, our findings are intended to caution providers about chronic opioid therapy as a risk factor for additional interventions and costs after lumbar fusion," said lead author Safdar Kahn, MD, an orthopedic spine surgeon at the Medical Center's Comprehensive Spine Center and Department Orthopaedic Surgery. "As we head toward a value- and outcomes-based reimbursement system, spine surgeons need to incorporate preoperative opioid use into their surgical decision making."

JoEllen McBride, PhD

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