Preoperative cannabis use in Canadian thoracolumbar spine surgery patients: a CSORN study

• Published in: Canadian Journal of Surgery 2022-12, Vol.65, p.S140-S140
• Main Authors: Fleury, Catherine, Bigney, Erin, Dumas, Evelyne, Elmughayyar, Dana, Cherry, Ahmed, Vanderwint, Amanda, Richardson, Eden, Kerr, J, McPhee, Rory, Abraham, Ed, Manson, Neil, Attabib, Najmedden, Small, Chris, Couture, Jérôme, Goulet, Julien, Bédard, Sonia, Larue, Bernard
• Format: Article
• Language: English
• Subjects: Back surgery; Marijuana; Mental health; Narcotics
• ISSN: 0008-428X; 1488-2310

Background: This study aims to (1) determine reported cannabis use among patients waiting for thoracolumbar surgery and to (2) identify demographics and health differences between cannabis users and noncannabis users. Methods: This observational cohort study is a retrospective national multicentre review using data from the Canadian Spine Outcomes and Research Network registry. Patients were dichotomized as cannabis users and noncannabis users. Variables of interest were age, sex, body mass index, smoking status, education, work status, exercise, modified Oswestry Disability Index (mODI), the numerical rating scales (NRS) for leg and back pain, tingling/numbness scale, SF-12 Quality of Life Questionnaire - Mental Health Component (MCS), and use of prescription cannabis, recreational cannabis and narcotic pain medication. Continuous variables were compared using an independent t test and categorical variables were compared using %2 analyses. Results: Cannabis use was reported by 28.4% of preoperative patients (n = 704), 47% of whom used prescription cannabis. Cannabis use was reported most often by patients in Alberta (43.6%), British Colombia (38.1%) and New Brunswick (33.7%). Patients who reported using cannabis were significantly younger (mean 52.9 yr v. mean 61.21 yr). There was a higher percentage of concurrent narcotic use (51.5%) and smoking (21.5%) reported in cannabis users in comparison with non cannabis users (41.1% [p = 0.001] and 9.5% [p = 0.001], respectively). There were significant differences in cannabis use on the basis of pathology (p = 0.01). Patients who reported using cannabis had significantly worse MCS scores (difference 3.93, p = 0.001) and PHQ-8 scores (difference 2.51, p = 0.001). There was a significant difference in work status (p = 0.002), with cannabis users reporting higher rates (20%) of being employed but not working compared with noncannabis users (11.1%). Noncannabis users were more likely to be retired (45.9%) compared with cannabis users (31.3%). There were no significant differences based on cannabis use for sex, education, exercise, NRS-back, NRS-Leg, tingling-leg, mODI or health state. Conclusion: Thoracolumbar spine surgery patients were utilizing cannabis before surgery both through recreational use and prescription. Patients who were using cannabis preoperatively did not differ in regard to reported pain or disability from nonusers, although they did in regard to demographic and mental health variables.