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Post-Operative Complications Associated with Long-Term NSAID or Long-Term Opioid Use Prior to Lumbar Spinal Fusion Surgery – Lumbar Fusion

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The article titled “Trends in Long-Term Preoperative NSAID and Opioid Use in Patients with Low Back Pain in the United States and Resultant Postoperative Complications Following Lumbar Fusion” investigates the usage trends of long-term preoperative NSAIDs and opioids in patients with low back pain in the United States. The authors conducted a retrospective cohort study using the 2010-2017 National Readmission Database and analyzed short-term (30-, 90-day) and long-term (180-, 300-day) complications following lumbar fusion surgery. They found a rise in opioid users and a decline in NSAID users after 2015. Opioid users had higher total inpatient charges and length of stay, while NSAID users had lower rates of acute infection and acute posthemorrhagic anemia. The study also indicated that NSAID use had significantly lower odds of readmission compared to opioid use at all time points. However, NSAID use was associated with higher odds of hardware failure at the long-term follow-up. Therefore, the authors concluded that opioid users had higher readmission rates, and NSAID use was associated with an increased risk of hardware failure in patients undergoing lumbar fusion surgery

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Published article

S: LTO users had significantly higher readmission rates compared to LTN. In addition, we found that LTN use was associated with significantly higher odds of hardware failure at long-term follow-up in patients receiving lumbar fusion surgery.

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Clin Neurol Neurosurg. 2023 Dec 19;236:108093. doi: 10.1016/j.clineuro.2023.108093. Online ahead of print.ABSTRACTOBJECTIVE: Lower back pain (LBP) has been implicated as a significant cause of chronic pain in the United States, often requiring analgesic use. In this study, we investigate the trends in long-term preoperative NSAID (LTN) and Opioid (LTO) use in patients with low back,

Clin Neurol Neurosurg. 2023 Dec 19;236:108093. doi: 10.1016/j.clineuro.2023.108093. Online ahead of print.

ABSTRACT

OBJECTIVE: Lower back pain (LBP) has been implicated as a significant cause of chronic pain in the United States, often requiring analgesic use. In this study, we investigate the trends in long-term preoperative NSAID (LTN) and Opioid (LTO) use in patients with low back pain in the United States, and the resultant postoperative complications following lumbar fusion.

METHODS: In this retrospective cohort study of patients with lumbar pathologies, multivariate population-based regression models were developed using the 2010-2017 National Readmission Database. Short-term complications (30-, 90-day) and long-term complications (180-, 300-day) were analyzed at readmission.

RESULTS: Of patients diagnosed with LBP (N = 1427,190) we found a rise in LTO users and a fall in LTN users following 2015. We identified 654,264 individuals who received a lumbar spine fusion, of which 22,975 were LTN users and 11,213 were LTO users. LTO users had significantly higher total inpatient charges (p-value<0.0001) and LOS (p-value<0.0001), while LTN users had lower rates of acute infection (OR: 0.993, 95% CI: 0.987-0.999, p = 0.017) and acute posthemorrhagic anemia (OR: 0.957, 95% CI: 0.935-0.979, p < 0.001) at primary admission. Readmission analysis showed that LTN use had significantly lower odds of readmission compared to LTO use at all time points (p < 0.01 for all). LTN use had significantly higher odds of hardware failure (OR: 1.134, 95% CI: 1.039-1.237, p = 0.005) within 300-days of receiving a lumbar fusion.

S: LTO users had significantly higher readmission rates compared to LTN. In addition, we found that LTN use was associated with significantly higher odds of hardware failure at long-term follow-up in patients receiving lumbar fusion surgery.

PMID:38183953 | DOI:10.1016/j.clineuro.2023.108093

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Post-Operative Complications Associated with Long-Term NSAID or Long-Term Opioid Use Prior to Lumbar Spinal Fusion Surgery

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Clin Neurol Neurosurg. 2023 Dec 19;236:108093. doi: 10.1016/j.clineuro.2023.108093. Online ahead of print.ABSTRACTOBJECTIVE: Lower back pain (LBP) has been implicated as a significant cause of chronic pain in the United States, often requiring analgesic use. In this study, we investigate the trends in long-term preoperative NSAID (LTN) and Opioid (LTO) use in patients with low back

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