• Raymaekers Vincent, Roosen Gert, Put Eric, Achahbar Salah-Eddine, Meeuws Sacha, Wissels Maarten, Bamps Sven, Vanvolsem Steven, Dirk De Ridder, Menovsky Tomas, and Plazier Mark.
• Department of Neurosurgery, Antwerp University Hospital, Antwerp, Belgium.
• Eur Spine J. 2024 Sep 1; 33 (9): 355935663559-3566.

PurposeLumbar spinal fusion surgeries are increasingly being performed in spinal degenerative disease, often accompanied by perioperative opioid prescriptions. The aim of this study is to analyze prolonged postoperative opioid use following a standardized opioid prescription after single-level lumbar spinal fusion surgery in a Belgian population.MethodsThis prospective, multicentric observational study included patients undergoing single-level lumbar fusion surgery for degenerative disease. A standardized postoperative opioid protocol (Targinact 2 × 10 mg/5 mg, Paracetamol 4 × 1 g and Ibuprofen 3 × 600 mg) was applied uniformly. Prolonged opioid use was defined as continued opioid use six months after surgery. Patient data were collected using the Back-App®.ResultsAmong 198 participants, 32.8% continued opioid use six months post-surgery, with 8% utilizing strong opioids. Prolonged opioid use correlated with lower pre-operative back pain. Patients with prolonged opioid use and strong opioid use at six months show less improvement in disability compared to patients without prolonged opioid use. Moreover, patients with prolonged strong opioid use tend to have lesser improvement of the low back pain. The odds for prolonged opioid use decrease with the increase of the improvement in ODI.Conclusion1 in 3 patients undergoing single-level lumbar spinal fusion surgery is at risk for prolonged opioid use. The study underscores the importance of tailored pain management strategies, particularly given the rising prevalence of spinal fusion surgeries. The association between pre-operative low back pain, post-operative improvement in functionality (ODI), and prolonged opioid use emphasizes the need for judicious opioid prescribing practices and highlights the role of functional outcomes in treatment goals.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

32 keywords...

hide…