• Junyoung Ahn, Daniel D Bohl, Islam Elboghdady, Khaled Aboushaala, Hamid Hassanzadeh, and Kern Singh.
• *Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL †Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; and ‡Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.
• Spine. 2015 Aug 15; 40 (16): 1284-8.

Study DesignRetrospective cohort analysis of a prospective registry.ObjectiveTo assess the differences in perioperative narcotic consumption between Workman's compensation (WC) and non-Workman's compensation (non-WC) patients after a single-level minimally invasive transforaminal lumbar interbody fusion.Summary Of Background DataThere is concern regarding the potential overutilization of opioid pain medication in WC patients. However, the impact of WC status on perioperative narcotic consumption after lumbar spine procedures has not been previously reported.MethodsA cohort of patients who underwent primary 1-level minimally invasive transforaminal lumbar interbody fusion procedures for degenerative spinal pathology between 2007 and 2013 was retrospectively analyzed using a prospectively collected registry. First, preoperative and perioperative characteristics were compared between WC and non-WC patients. Second, mean oral morphine equivalent was compared between WC and non-WC patients with adjustment for any preoperative or perioperative differences between cohorts.ResultsA total of 136 single-level, primary minimally invasive-transforaminal lumbar interbody fusion procedures were included in the analysis, of which 46 (33.8%) were WC patients. WC patients were younger (47.8 ± 11.2 vs. 57.9 ± 10.4 yr; P < 0.001) and had a lower comorbidity burden (Charlson Comorbidity Index: 1.85 ± 1.30 vs. 3.42 ± 2.07; P < 0.001) than non-WC patients. The distribution of ethnicity differed between WC and non-WC patients (P = 0.002). WC patients incurred longer procedural times (135.2 ± 52.2 vs. 118.9 ± 33.7 min; P < 0.05). However, the estimated blood loss, length of hospital stay, and day of discharge were no different between WC and non-WC patients. Mean oral morphine equivalent consumption did not differ between WC and non-WC patients after adjustment for differences in age, ethnicity, Charlson Comorbidity Index, and procedural time between cohorts.ConclusionDespite concerns for greater opioid use in the WC population, this analysis demonstrated similar total narcotic consumption between WC and non-WC patients during the immediate postoperative period. Long-term studies are warranted to assess whether this similarity in regard to perioperative narcotic consumption persists beyond the immediate postoperative period.Level Of Evidence3.

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