March 2024

ORTHOPAEDICS

DRIVERS OF PERSISTENT OPIOID USE AND ITS IMPACT ON HEALTHCARE UTILIZATION AFTER ELECTIVE SPINE SURGERY

Featuring: Srikanth N. Divi, MD, Wellington K. Hsu, MD and Alpesh A. Patel, MD, MBA

​Published in Global Spine Journal, “The Drivers of Persistent Opioid Use and Its Impact on Healthcare Utilization After Elective Spine Surgery” is a retrospective cohort study that aims to identify the incidence and risk factors for persistent opioid use following elective cervical and lumbar spine procedures. The study also seeks to quantify the postoperative healthcare utilization in this patient population. Patients who underwent elective spine surgery for either cervical or lumbar degenerative pathology between November 1, 2013, and September 30, 2018, at a single academic center were retrospectively identified and split into two cohorts: those with and without opioid use at 180-days postoperatively.

The study found that out of the 583 patients who met the inclusion criteria, 16.6% had persistent opioid use after surgery. Persistent opioid use was associated with an ASA score of ≥3, diabetes, class I obesity, and an opioid prescription in the 60 days before surgery. Independent risk factors for opioid persistence, as assessed via multivariate regression, included multi-level lumbar fusion, cervical central stenosis, and pre-operative opioid use. The study concluded that opioid persistence is associated with higher rates of healthcare utilization within 1 year after elective spine surgery, including more radiographs, CT scans, MRI studies, emergency department visits, pain medicine referrals, and spinal injections.
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To read the full publication, visit Global Spine Journal.
Srikanth N. Divi, MD, Assistant Professor of Orthopaedic Surgery and Neurological Surgery
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Wellington K. Hsu, MD, Professor of Orthopaedic Surgery and Neurological Surgery
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Alpesh A. Patel, MD, MBA, Professor of Orthopaedic Surgery and Neurological Surgery
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