Chronic opioid therapy lumbar patients are at greater risk of complications and adverse outcomes which included repeated spinal fusion surgery according to researchers at Ohio State University. Researchers say that increasing emphasis on quality of improvement and cost control these findings are meant to serve as caution to medical providers about chronic opioid therapy as a risk factor for additional interventions and associated costs.
Using insurance databases 24,610 patients were identified who underwent spinal fusion in the lower spine, of which 22% were taking opioids for more than 6 months prior to surgery. Several factors were linked to increased rate of chronic opioid therapy which includes drug abuse and dependence, tobacco use disorder, depression, inflammatory arthritis, and anxiety.
It was found that a wide range of complications were more frequent among patients who were long term opioid users, such as within the first 90 days following surgery odds of surgical wound complications were 19% higher; it was also associated with higher likelihood of ER department visits and/or hospitalizations within the first 90 days after surgery, with issues related to lumbar pain being especially high having 31% increased ER visits and 80% more hospital admissions; patients were also 8 times more likely to be still continuing to take opioids one year afterwards; and were at 33% increased risk for likelihood of repeat spinal fusion surgery within one year. Chronic opioid users were also found to be at higher odds for other complications such as constipation.
The cycle of unrelieved pain and fusion with increased healthcare costs in long term opioid use have been highlighted in this study which adds to a growing body of work. Many people take opiods for back pain for many months before spinal fusion surgery. It has previously been shown in several studies that there are numerous negative effects from opioid use on outcomes after surgery. This study was focussed on how chronic opioid therapy affects cost and risks after undergoing the most common type of spinal fusion surgery intervention.
Researchers say that these results suggest that one fourth of lumbar patients are long term opioid users before undergoing spinal fusion surgery, and these chronic users have increased complication rates which include ER department visits, wound complications, hospital admissions for back pain, and repeat surgery. Spine surgeons should be aware and vigilant of increased complications and associated costs of chronic opioid therapy states researchers.
