Total Inpatient Morphine Milligram Equivalents Can Predict Long-term Opioid Use After Transforaminal Lumbar Interbody Fusion

被引:21
|
作者
Ge, David H. [1 ]
Hockley, Aaron [1 ]
Vasquez-Montes, Dennis [1 ]
Moawad, Mohamed A. [1 ]
Passias, Peter G. [1 ]
Errico, Thomas J. [2 ]
Buckland, Aaron J. [1 ]
Protopsaltis, Themistocles S. [1 ]
Fischer, Charla R. [1 ]
机构
[1] NYU, Dept Orthopaed Surg, Div Spine Surg, Langone Orthoped Hosp, 145 E 32nd St 4th Fl, New York, NY 10016 USA
[2] Nicklaus Childrens Hosp, Ctr Spinal Disorders, Miami, FL USA
关键词
morphine milligram equivalents; opioid use; postoperative opioid dependence; transforaminal lumbar interbody fusion; PREOPERATIVE NARCOTIC USE; REPORTED DRUG-USE; POSTOPERATIVE PAIN; SPINE SURGERY; COMPLICATIONS; ASSOCIATION; MANAGEMENT; VALIDITY; LENGTH; STAY;
D O I
10.1097/BRS.0000000000003106
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. A retrospective cohort study from a single institution. Objective. The aim of this study was to assess the thresholds for postoperative opioid consumption, which are predictive of continued long-term opioid dependence. Summary of Background Data. The specific sum total of inpatient opioid consumption as a risk factor for long-term use after transforaminal lumbar interbody fusion (TLIF) has not been previously studied. Methods. Charts of patients who underwent a one, two, or three-level primary TLIF between 2014 and 2017 were reviewed. Total morphine milligram equivalents (MME) consumed was tabulated and separated into three categories based on ROC curve analysis of opioid utilization at 6-month follow-up. Multivariate binary regression analysis assessed these MME dosage categories. A further subanalysis grouped patients on the basis of whether they had used opioids preoperatively. Results. One hundred seventy-two patients met the inclusion criteria and were separated into groups who received less than 250 total inpatient MME (44%), between 250 and 500 total inpatient MME (26%), and greater than 500 total inpatient MME (27%). Patients undergoing a TLIF who received <250 total MME in the immediate postoperative period had a 3.73 (odds ratio) times smaller probability of requiring opioids at 6-month follow-up [P = 0.027, 95% confidence interval (95% CI) 0.084-0.86]. Patients who received >500 total MME had a 4.84 times greater probability (P = 0.002, 95% CI 1.8-13) of requiring opioids at 6-month follow-up. A subanalysis demonstrated individuals with preoperative opioid use who received <250 total MME had a 7.09 times smaller probability (P = 0.033, 95% CI 0.023-0.85) of requiring opioids at 6-month follow-up while those who received >500 total MME had a 5.43 times greater probability (P = 0.033, 95% CI 1.6-18) of requiring opioids at 6-month follow-up. Conclusion. Exceeding the threshold of 500 total MMEs in the immediate postoperative period after a TLIF is a significant risk factor that predicts continued opioid use at 6-month follow-up, particularly among patients with a history of preoperative opioid utilization.
引用
收藏
页码:1465 / 1470
页数:6
相关论文
共 50 条
  • [31] Comparison of the Stopping Opioids after Surgery (SOS) score to preoperative morphine milligram equivalents (MME) for prediction of opioid prescribing after lumbar spine surgery
    Karhade, Aditya, V
    Schwab, Joseph H.
    Harris, Mitchel B.
    Schoenfeld, Andrew J.
    SPINE JOURNAL, 2020, 20 (11): : 1798 - 1804
  • [32] Short-term and long-term outcomes of minimally invasive and open transforaminal lumbar interbody fusions: is there a difference?
    Cheng, Jason S.
    Park, Priscilla
    Le, Hai
    Reisner, Lori
    Chou, Dean
    Mummaneni, Praveen V.
    NEUROSURGICAL FOCUS, 2013, 35 (02)
  • [33] Long-Term Durability of Stand-Alone Lateral Lumbar Interbody Fusion
    Agarwal, Nitin
    White, Michael D.
    Roy, Souvik
    Ozpinar, Alp
    Alan, Nima
    Lavadi, Raj Swaroop
    Okonkwo, David O.
    Hamilton, D. Kojo
    Kanter, Adam S.
    NEUROSURGERY, 2023, 93 (01) : 60 - 65
  • [34] Long-term follow-up of the anterior lumbar interbody fusion procedure
    Verbruggen, Dimitri
    Tampere, Thomas
    Uyttendaele, Dirk
    Sys, Gwen
    Poffyn, Bart
    ACTA ORTHOPAEDICA BELGICA, 2015, 81 (03): : 546 - 552
  • [35] Long-term follow-up study of posterior lumbar interbody fusion
    Nakai, S
    Yoshizawa, H
    Kobayashi, S
    JOURNAL OF SPINAL DISORDERS, 1999, 12 (04): : 293 - 299
  • [36] Development and validation of a nomogram to predict the risk of adjacent segment disease after transforaminal lumbar interbody fusion in patients with lumbar degenerative diseases
    Yu, Miao
    Ye, Jiawen
    Xing, Hui
    Yin, Hong
    Jiang, Tao
    Liu, Minghan
    Li, Changqing
    JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2024, 19 (01):
  • [37] Quality-of-Life Outcomes With Minimally Invasive Transforaminal Lumbar Interbody Fusion Based on Long-Term Analysis of 304 Consecutive Patients
    Perez-Cruet, Mick J.
    Hussain, Namath S.
    White, Zachary
    Begun, Evan M.
    Collins, Robert A.
    Fahim, Daniel K.
    Hiremath, Girish K.
    Adbi, Fadumo M.
    Yacob, Sammy A.
    SPINE, 2014, 39 (03) : E191 - E198
  • [38] Commentary: Minimally Invasive Transforaminal Lumbar Interbody Fusion for 2-Level Degenerative Lumbar Disease in Patients With Osteoporosis: Long-Term Clinical and Radiographic Outcomes
    Alomari, Safwan
    Bydon, Ali
    OPERATIVE NEUROSURGERY, 2021, 20 (06) : E396 - E397
  • [39] The Effect of Preoperative Medications on Length of Stay, Inpatient Pain, and Narcotics Consumption After Minimally Invasive Transforaminal Lumbar Interbody Fusion
    Haws, Brittany E.
    Khechen, Benjamin
    Patel, Dil, V
    Bawa, Mundeep S.
    Guntin, Jordan A.
    Cardinal, Kaitlyn L.
    Wiggins, Adam B.
    Singh, Kern
    CLINICAL SPINE SURGERY, 2019, 32 (01): : E37 - E42
  • [40] Letter re: Letter to the Editor Concerning 'Long-Term Incidence of Adjacent Segmental Pathology after Minimally Invasive vs. Open Transforaminal Lumbar Interbody Fusion'
    Niu, Sitian
    Li, Ranran
    Wang, Jingzhi
    GLOBAL SPINE JOURNAL, 2025, 15 (02) : 1459 - 1459