2026-04-18T02:09:22Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/129312025-10-24T10:42:16Zcom_2072_378070com_2072_378040col_2072_378092

Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands Sardi, Juan Pablo Smith, Justin S. Gum, Jeffrey Rocos, Brett Charalampidis, Anastasios Lenke, Lawrence Pellise, Ferran Institut Català de la Salut [Sardi JP, Smith JS] Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA. [Gum JL] Norton Leatherman Spine Center, Louisville, KY, USA. [Rocos B] Departments of Neurosurgery and Orthopedic Surgery, Duke University, Durham, NC, USA. [Charalampidis A] Department of Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden. Department of Clinical Science, Intervention and Technology (CLINITEC), Karolinska Institutet, Stockholm, Sweden. [Lenke LG] Department of Orthopedic Surgery, Columbia University, New York, NY, USA. [Pellisé F] Servei de Cirurgia Ortopèdica i Traumatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Columna vertebral - Cirurgia Pèptids opioides - Ús terapèutic - Efectes secundaris Dorsàlgia Columna vertebral - Malformacions CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Central Nervous System Depressants::Narcotics::Analgesics, Opioid Other subheadings::Other subheadings::Other subheadings::/adverse effects ANATOMY::Musculoskeletal System::Skeleton::Bone and Bones::Spine Other subheadings::Other subheadings::Other subheadings::/surgery DISEASES::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Neurologic Manifestations::Pain::Back Pain COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::efectos fisiológicos de los fármacos::depresores del sistema nervioso central::narcóticos::analgésicos opioides Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias óseas::neoplasias de la columna vertebral Otros calificadores::Otros calificadores::Otros calificadores::/cirugía ENFERMEDADES::afecciones patológicas, signos y síntomas::signos y síntomas::manifestaciones neurológicas::dolor::dolor de espalda Opioid use; Pain management; Spine surgery Consum d'opioides; Gestió del dolor; Cirurgia de la columna vertebral Consumo de opioides; Gestión del dolor; Cirugía de la columna vertebral Study Design Prospective multicenter database post-hoc analysis. Objectives Opioids are frequently prescribed for painful spinal conditions to provide pain relief and to allow for functional improvement, both before and after spine surgery. Amidst a current opioid epidemic, it is important for providers to understand the impact of opioid use and its relationship with patient-reported outcomes. The purpose of this study was to evaluate pre-/postoperative opioid consumption surrounding ASD and assess patient-reported pain outcomes in older patients undergoing surgery for spinal deformity. Methods Patients ≥60 years of age from 12 international centers undergoing spinal fusion of at least 5 levels and a minimum 2-year follow-up were included. Patient-reported outcome scores were collected using the Numeric Rating Scale for back and leg pain (NRS-B; NRS-L) at baseline and at 2 years following surgery. Opioid use, defined based on a specific question on case report forms and question 11 from the SRS-22r questionnaire, was assessed at baseline and at 2-year follow-up. Result Of the 219 patients who met inclusion criteria, 179 (81.7%) had 2-year data on opioid use. The percentages of patients reporting opioid use at baseline (n = 75, 34.2%) and 2 years after surgery (n = 55, 30.7%) were similar (P = .23). However, at last follow-up 39% of baseline opioid users (Opi) were no longer taking opioids, while 14% of initial non-users (No-Opi) reported opioid use. Regional pre- and postoperative opioid use was 5.8% and 7.7% in the Asian population, 58.3% and 53.1% in the European, and 50.5% and 40.2% in North American patients, respectively. Baseline opioid users reported more preoperative back pain than the No-Opi group (7.0 vs 5.7, P = .001), while NRS-Leg pain scores were comparable (4.8 vs 4, P = .159). Similarly, at last follow-up, patients in the Opi group had greater NRS-B scores than Non-Opi patients (3.2 vs 2.3, P = .012), but no differences in NRS-Leg pain scores (2.2 vs 2.4, P = .632) were observed. Conclusions In this study, almost one-third of surgical ASD patients were consuming opioids both pre- and postoperatively world-wide. There were marked international variations, with patients from Asia having a much lower usage rate, suggesting a cultural influence. Despite both opioid users and nonusers benefitting from surgery, preoperative opioid use was strongly associated with significantly more back pain at baseline that persisted at 2-year follow up, as well as persistent postoperative opioid needs. 2025-04-10T12:00:19Z 2025-04-10T12:00:19Z 2025-04 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Sardi JP, Smith JS, Gum JL, Rocos B, Charalampidis A, Lenke LG, et al. Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands. Glob Spine J. 2025 Apr;15(3):1749–59. 2192-5690 http://hdl.handle.net/11351/12931 10.1177/21925682241261662 38832400 http://hdl.handle.net/11351/12931 eng Global Spine Journal;15(3) https://doi.org/10.1177/21925682241261662 Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess application/pdf SAGE Publications Scientia