Predictors of long-term opioid dependence in transforaminal lumbar interbody fusion with a focus on pre-operative opioid usage

Purpose Predictors of long-term opioid usage in TLIF patients have not been previously explored in the literature. We examined the effect of pre-operative narcotic use in addition to other predictors of the pattern and duration of post-operative narcotic usage. Methods We conducted a retrospective c...

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Bibliographic Details
Published in:European spine journal 2020-06, Vol.29 (6), p.1311-1317
Main Authors: Hockley, Aaron, Ge, David, Vasquez-Montes, Dennis, Moawad, Mohamed A., Passias, Peter Gust, Errico, Thomas J., Buckland, Aaron J., Protopsaltis, Themistocles S., Fischer, Charla R.
Format: Article
Language:English
Subjects:
Chronic pain
Drug dependence
Medicine
Medicine & Public Health
Morphine
Muscle relaxants
Narcotics
Neurosurgery
Opioids
Original Article
Surgical Orthopedics
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Summary:Purpose Predictors of long-term opioid usage in TLIF patients have not been previously explored in the literature. We examined the effect of pre-operative narcotic use in addition to other predictors of the pattern and duration of post-operative narcotic usage. Methods We conducted a retrospective cohort study at a single academic institution of patients undergoing a one- or two-level primary TLIF between 2014 and 2017. Total oral morphine milligram equivalents (MMEs) for inpatient use were calculated and used as the common unit of comparison. Results A multivariate binary logistic regression ( R 2  = 0.547, specificity 95%, sensitivity 58%) demonstrated that a psychiatric or chronic pain diagnosis (OR 3.95, p  = 0.013, 95% CI 1.34–11.6), pre-operative opioid use (OR 8.65, p  
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-020-06345-3