Patients who have spine surgery are less likely to be dependent on opioids after surgery, new research confirms.
Opioid misuse is recognised as a serious public health problem in the United States. Researchers at the University of Louisville set out to identify risk factors associated with opioid dependence in patients undergoing surgery for degenerative spondylolisthesis (DS), a condition in which a bone in the spine (vertebra) slips out of position, either forwards or backwards, compressing the nerves in the spinal column.
DS occurs as a consequence of the ageing process, with the bones, joints and ligaments in the spine becoming weak and less able to hold the spinal column in alignment.
In the new study, published in the Journal of Neurosurgery: Spine, the authors analysed records for 10,708 patients who had surgery for DS between 2000 and 2012. Most of the patients received decompression and fusion surgery for the condition.
“Spine surgery patients deal with an immense amount of pain both before and after surgery. Opioids are used to manage that pain,” explained Mayur Sharma from the Department of Neurological Surgery at the University of Louisville, who led the study.
In the year before the surgery, 14.85% of the patients were opioid dependent. Three to 15 months after the procedure, 9.9% were opioid dependent.
“Our work indicates that surgery for degenerative spondylolisthesis is associated with a reduced risk of opioid dependence,” Sharma said.
Younger age and prior opioid dependence were associated with a higher risk for post-surgery opioid dependence, the authors noted.
Similarly, a separate study published in the Journal of Bone & Joint Surgery found that patients who take prescription opioids for a longer period before spinal surgery are more likely to continue using the drugs several months after surgery.
The research — which included 27,031 patients who underwent lumbar interbody arthrodesis, lumbar discectomy, lumbar decompression or lumbar posterolateral arthrodesis — revealed that 8.8% of patients were still taking opioids six months after surgery. Duration of opioid use before surgery was the main risk factor for continued use.
Two thirds (67%) of the patients stopped taking opioids within 30 days, and 86% were no longer taking opioids at 90 days.