The clinical impact of nano-surface technology on postoperative opioid consumption in patients undergoing anterior lumbar interbody fusion

• Published in: Canadian Journal of Surgery 2022-12, Vol.65, p.S155-S155
• Main Authors: Slosar, Paul, McAnany, Steven, Cheung, Aaron, Dewitt, David
• Format: Article
• Language: English
• Subjects: Narcotics; Postoperative period; Transplants & implants
• ISSN: 0008-428X; 1488-2310

Background: The aim of this study was to determine if published cellular advantages linked with nano-surface technology on interbody fusion implants are associated with clinical benefits of less opioid consumption postoperatively after anterior lumbar interbody fusion (ALIF). Methods: This is a retrospective cohort study of consecutively treated patients undergoing ALIF. Patients received control or investigational interbody fusion implants without or with nanosurface technology, respectively. Patients were assessed at 3 postoperative follow-up visits for opioid use and total daily morphine milligram equivalents (MME) consumption with a minimum follow-up of 3 months. A logistic multivariate regression was performed to identify factors predictive of opioid use at final follow-up. Two-way repeated measures analysis of variance was used to compare the groups at each time point. Results: A total of 120 patients were included in the analysis, with 61 patients receiving the control interbody fusion device without nano-surface technology and 59 receiving the investigational fusion device with nano-surface technology. Regression analysis demonstrated that the surface of the interbody fusion implants and smoking status were statistically significant predictors of opioid use. Patients with the control interbody implant had 4.50 times higher odds to use opioids at the 3-month follow-up compared with patients with the investigational interbody implant. Daily MME was statistically significantly higher at baseline and at each postoperative follow-up in patients with the control interbody implant compared with patients with the investigational interbody implant (13.4 mg/L v. 5.42 mg/L, p = 0.005, baseline; 46.83 mg/L v. 9.63 mg/L, p < 0.001, postoperative 1; 23.68 mg/L v. 1.46 mg/L, p < 0.001, postoperative 2; 10.92 mg/L v 1.00 mg/L, < 0.001, postoperative 3). Lower preoperative MME and absence of preoperative opioid usage were not significant predictors of reduced opioid consumption at final follow-up. Conclusion: These results suggest that patients implanted with interbody fusion implants with nano-surface technology during ALIF may have a contributory effect on lowering the amount and duration of opioid medications in the early postoperative time period, compared with standard interbody fusion implants without nano-surface technology.