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Cannabis Use is Associated with Higher Rates of Pseudarthrosis Following TLIF: A Multi-Institutional Matched-Cohort Study – Published Article

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The article examines the rates of pseudarthrosis, a condition where there is a failure of bone fusion, in patients undergoing 1-3 level Transforaminal Lumbar Interbody Fusion (TLIF) procedures and compares the outcomes between cannabis users and non-cannabis users. The study found that patients who used cannabis were 80% more likely to experience pseudarthrosis compared to non-cannabis users. Cannabis use was also associated with higher rates of all-cause surgical complications and all-cause medical complications. The findings suggest that cannabis use may have negative effects on bone fusion and overall surgical outcomes. Further research is needed to validate these findings

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine centre on Harley Street UK

Published article

CONCLUSION: After 1:1 exact matching to control for confounding variables, the findings of this study suggest that cannabis use is associated with higher rates of pseudarthrosis, as well as higher rates of all-cause surgical and all-cause medical complications. Further studies are needed to corroborate our findings.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2023 Jul 3. doi: 10.1097/BRS.0000000000004768. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort.OBJECTIVE: To compare the rates of pseudarthrosis in patients undergoing 1-3 level Transforaminal Lumbar Interbody Fusion (TLIF) procedures between cannabis users and non-cannabis users.SUMMARY OF BACKGROUND DATA: Recreational use of cannabis is common, though it remains poorly studied and legally,

Spine (Phila Pa 1976). 2023 Jul 3. doi: 10.1097/BRS.0000000000004768. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort.

OBJECTIVE: To compare the rates of pseudarthrosis in patients undergoing 1-3 level Transforaminal Lumbar Interbody Fusion (TLIF) procedures between cannabis users and non-cannabis users.

SUMMARY OF BACKGROUND DATA: Recreational use of cannabis is common, though it remains poorly studied and legally ambiguous in the United States. Patients with back pain may turn to adjunctive use of cannabis to manage their pain. However, the implications of cannabis use on the achievement of bony fusion are not well-characterized.

METHODS: Patients who underwent 1-3 level TLIF for degenerative disc disease (DDD) or degenerative spondylolisthesis (DS) between 2010-2022 were identified using the PearlDiver Mariner all-claims insurance database. Cannabis users were identified with ICD 10 code F12.90. Patients undergoing surgery for non-degenerative pathologies such as tumors, trauma, or infection were excluded. 1:1 exact matching was performed using demographic factors, medical comorbidities, and surgical factors which were significantly associated with pseudarthrosis in a linear regression model. The primary outcome measure was development of pseudarthrosis within 24 months after 1-3 level TLIF. The secondary outcomes were the development of all-cause surgical complications as well as all-cause medical complications.

RESULTS: 1:1 exact matching resulted in two equal groups of 1,593 patients who did or did not use cannabis and underwent 1-3 level TLIF. Patients who used cannabis were 80% more likely to experience pseudarthrosis compared to patients who do not (RR 1.816, 95% CI 1.291-2.556, P<0.001). Similarly, cannabis use was associated with significantly higher rates of all-cause surgical complications (RR 2.350, 95% CI 1.399-3.947, P=0.001) and all-cause medical complications (RR 1.934, 95% CI 1.516-2.467, P<0.001).

CONCLUSION: After 1:1 exact matching to control for confounding variables, the findings of this study suggest that cannabis use is associated with higher rates of pseudarthrosis, as well as higher rates of all-cause surgical and all-cause medical complications. Further studies are needed to corroborate our findings.

LEVEL OF EVIDENCE: III.

PMID:37417709 | DOI:10.1097/BRS.0000000000004768

The London Spine Unit : innovative spine centre on Harley Street UK

Read the original publication:

Cannabis Use is Associated with Higher Rates of Pseudarthrosis Following TLIF: A Multi-Institutional Matched-Cohort Study

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Spine (Phila Pa 1976). 2023 Jul 3. doi: 10.1097/BRS.0000000000004768. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort.OBJECTIVE: To compare the rates of pseudarthrosis in patients undergoing 1-3 level Transforaminal Lumbar Interbody Fusion (TLIF) procedures between cannabis users and non-cannabis users.SUMMARY OF BACKGROUND DATA: Recreational use of cannabis is common, though it remains poorly studied and legally

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