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Risks Associated with Chronic Cannabis Use on Opioid Use, Length of Stay, and Revision Rate for Patients Undergoing Posterior Lumbar Interbody Fusion – Lumbar Fusion

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This article discusses the potential effects of cannabis use on perioperative opioid requirement and revision surgery rate in patients undergoing lumbar fusion. The study used a retrospective cross-sectional design and analyzed the data of 48,499 patients from the PearlDiver national database who had undergone posterior lumbar interbody fusion. The results showed that chronic cannabis users had higher rates and amounts of opioid use both before and after the surgery, compared to non-users. Cannabis users also had a longer length of stay and a higher rate of revision surgery. The study concludes that chronic cannabis use is associated with increased opioid use, longer hospital stays, and an increased revision rate

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spine hospital in UK

Published article

S: Chronic cannabis use is associated with an increased preoperative and long-term postoperative opioid use, a longer length of stay, and an increased revision rate.

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Spine J. 2024 Feb 1:S1529-9430(24)00015-9. doi: 10.1016/j.spinee.2024.01.011. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Opioids are commonly prescribed to treat spinal pain, especially those undergoing surgery. Cannabis has been suggested as an agent that can modulate opioid needs in these patients.PURPOSE: To investigate the effect of cannabis use on perioperative opioid requirement and revision surgery rate in,

Spine J. 2024 Feb 1:S1529-9430(24)00015-9. doi: 10.1016/j.spinee.2024.01.011. Online ahead of print.

ABSTRACT

BACKGROUND CONTEXT: Opioids are commonly prescribed to treat spinal pain, especially those undergoing surgery. Cannabis has been suggested as an agent that can modulate opioid needs in these patients.

PURPOSE: To investigate the effect of cannabis use on perioperative opioid requirement and revision surgery rate in patients undergoing lumbar fusion.

STUDY DESIGN: Retrospective cross-sectional study PATIENT SAMPLE: 48,499 patients from PearlDiver national database who underwent posterior lumbar interbody fusion.

OUTCOME MEASURES: Opioid-use rates, MME, length of stay, and revision rates.

METHODS: Using PearlDiver, we identified patients for posterior lumbar interbody fusion (PLIF), cannabis use disorder, revision lumbar fusion, demographics, and comorbidities. Cannabis users and non-users were propensity matched for age, sex, and tobacco use. Pre- and post-operative cumulative morphine milli equivalence (MME) were calculated. Opioid-use rates, MME, length of stay (LOS), and revision rates were compared using univariate analysis. Revision rates were compared using Kaplan-Meyer log-rank analysis, and logistic and cox regression.

RESULTS: Of 48,499 patients undergoing PLIF, 3.4% were identified as chronic cannabis users. They were younger, and more likely to be male and use tobacco. They had a higher rate and amount of opioid use within 90-days preoperatively, and 90- and 365-days postoperatively, after controlling for age, sex, and tobacco use. Cannabis users had longer LOS (4.4 vs 4.0 days), and a higher rate of revision surgery (6.9% vs 3.2%). Log-rank analysis, as well as logistic and cox regression confirmed an increased revision rate. Concurrent tobacco and cannabis use also had an additive effect on revision rate to 8.1%, compared with those who used only cannabis (5.4%) or tobacco (4.5%).

S: Chronic cannabis use is associated with an increased preoperative and long-term postoperative opioid use, a longer length of stay, and an increased revision rate.

PMID:38309626 | DOI:10.1016/j.spinee.2024.01.011

The London Spine Unit : innovative spine hospital in UK

Read the original publication:

Risks Associated with Chronic Cannabis Use on Opioid Use, Length of Stay, and Revision Rate for Patients Undergoing Posterior Lumbar Interbody Fusion

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Spine J. 2024 Feb 1:S1529-9430(24)00015-9. doi: 10.1016/j.spinee.2024.01.011. Online ahead of print.ABSTRACTBACKGROUND CONTEXT: Opioids are commonly prescribed to treat spinal pain, especially those undergoing surgery. Cannabis has been suggested as an agent that can modulate opioid needs in these patients.PURPOSE: To investigate the effect of cannabis use on perioperative opioid requirement and revision surgery rate in

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