HealthDay News — Preoperative chronic opioid use is associated with poor outcomes and continued dependence after posterior lumbar fusion, according to a study published online March 20 in Spine.

Nikhil Jain, MD, from The Ohio State University in Columbus, and colleagues used commercial insurance data (from 2007 to Q3-2015) to evaluate preoperative opioid use in 24,610 patients undergoing primary 1- and 2-level posterior lumbar fusion. The authors also assessed associated 90-day complications, emergency department visits, readmissions, 1-year adverse events, and costs. 

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The researchers found that 22.3% of patients had documented opioid use for more than 6 months before surgery, and 87.4% of these had continued long-term use postoperatively. Preoperative chronic opioid use was associated with higher risk for 90-day wound complications, pain diagnoses, emergency department visits, readmission, and continued postoperative use. Additionally, 1 year after surgery, long-term opioid users had an increased risk for epidural/facet joint injections, revision fusion, and new onset constipation.

“Preoperative chronic opioid therapy is a modifiable risk factor for complications, readmission, adverse events, and increased costs after one- and two-level posterior lumbar fusion,” the authors write.

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