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Nationwide Analysis of Risk Factors Related to Opioid Weaning Following Lumbar Decompression Surgery – A Retrospective Database Study – Lumbar Spinal Stenosis

The article examines the relationship between preoperative opioid use and postoperative complete opioid weaning among lumbar decompression patients. A study conducted on patients who underwent lumbar decompression in the years 2008-2017 found that patients who used opioids for longer periods before surgery were less likely to completely wean off opioids postoperatively. Patients with higher preoperative doses were also less likely to wean off opioids after surgery. Factors such as obesity increased the likelihood of weaning, while older age, several comorbidities, female sex, and Medicaid decreased the odds of weaning. These findings may help inform expectations regarding opioid use following lumbar decompression surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

CONCLUSIONS: Patients who used opioids for longer preoperatively were less likely to completely wean following surgery. Among patients with >180 days of preoperative use, those with lower preoperative doses were more likely to wean. Weaning was also associated with several clinical and demographic factors. These findings may help shape expectations regarding opioid use following lumbar decompression.

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World Neurosurg. 2024 Mar 20:S1878-8750(23)01746-1. doi: 10.1016/j.wneu.2023.12.025. Online ahead of print.ABSTRACTBACKGROUND: Opioids are often prescribed for patients who eventually undergo lumbar decompression. Given the potential for opioid-related morbidity and mortality, postoperative weaning is often a goal of surgery. The purpose of this study was to examine the relationship between preoperative opioid use and postoperative complete,

World Neurosurg. 2024 Mar 20:S1878-8750(23)01746-1. doi: 10.1016/j.wneu.2023.12.025. Online ahead of print.

ABSTRACT

BACKGROUND: Opioids are often prescribed for patients who eventually undergo lumbar decompression. Given the potential for opioid-related morbidity and mortality, postoperative weaning is often a goal of surgery. The purpose of this study was to examine the relationship between preoperative opioid use and postoperative complete opioid weaning among lumbar decompression patients.

METHODS: We surveyed the IBM Marketscan Databases for patients who underwent lumbar decompression in 2008-2017, had >30 days of opioid use in the year preceding surgery, and consumed a daily average of >0 morphine milligram equivalents (MME) in the 3 months preceding surgery. We used multivariable logistic regression and marginal standardization to examine the association between preoperative opioid use duration, average daily dose, and their interactions with complete opioid weaning in the 10-12 months after surgery.

RESULTS: Of the 11,114 patients who met inclusion criteria, most (54.7%, n=6083) had a preoperative average daily dose of 1-20 MME. Postoperatively, 6144 patients (55.3%) remained on opioids. For patients with >180 days of preoperative use, the adjusted probability of weaning increased as the preoperative dose decreased. Obesity increased the likelihood of weaning, whereas older age, several comorbidities, female sex, and Medicaid decreased the odds of weaning.

CONCLUSIONS: Patients who used opioids for longer preoperatively were less likely to completely wean following surgery. Among patients with >180 days of preoperative use, those with lower preoperative doses were more likely to wean. Weaning was also associated with several clinical and demographic factors. These findings may help shape expectations regarding opioid use following lumbar decompression.

PMID:38519019 | DOI:10.1016/j.wneu.2023.12.025

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Nationwide Analysis of Risk Factors Related to Opioid Weaning Following Lumbar Decompression Surgery – A Retrospective Database Study

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World Neurosurg. 2024 Mar 20:S1878-8750(23)01746-1. doi: 10.1016/j.wneu.2023.12.025. Online ahead of print.ABSTRACTBACKGROUND: Opioids are often prescribed for patients who eventually undergo lumbar decompression. Given the potential for opioid-related morbidity and mortality, postoperative weaning is often a goal of surgery. The purpose of this study was to examine the relationship between preoperative opioid use and postoperative complete

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