Postoperative Opioid Prescription and Patient-reported Outcomes After Elective Spine Surgery: a Michigan Spine Surgery Improvement Collaborative Study.

Authors

Seokchun Lim
Hsueh-Han Yeh
Mohamed Macki
Sameah Haider
Travis Hamilton
Tarek R Mansour
Edvin Telemi
Lonni Schultz
David R Nerenz
Jason M Schwalb
Muwaffak Abdulhak
Paul Park
Ilyas Aleem
Richard Easton, Beaumont Health
Jad G. Khalil, Beaumont Health
Miguelangelo Perez-Cruet, Beaumont Health
Victor Chang

Document Type

Article

Publication Date

10-7-2022

Publication Title

Journal of Neurosurgery. Spine

Abstract

OBJECTIVE: This study was designed to assess how postoperative opioid prescription dosage could affect patient-reported outcomes after elective spine surgery.

METHODS: Patients enrolled in the Michigan Spine Surgery Improvement Collaborative (MSSIC) from January 2020 to September 2021 were included in this study. Opioid prescriptions at discharge were converted to total morphine milligram equivalents (MME). A reference value of 225 MME per week was used as a cutoff. Patients were divided into two cohorts based on prescribed total MME: ≤ 225 MME and > 225 MME. Primary outcomes included patient satisfaction, return to work status after surgery, and whether improvement of the minimal clinically important difference (MCID) of the Patient-Reported Outcomes Measurement Information System 4-question short form for physical function (PROMIS PF) and EQ-5D was met. Generalized estimated equations were used for multivariate analysis.

RESULTS: Regression analysis revealed that patients who had postoperative opioids prescribed with > 225 MME were less likely to be satisfied with surgery (adjusted OR [aOR] 0.81) and achieve PROMIS PF MCID (aOR 0.88). They were also more likely to be opioid dependent at 90 days after elective spine surgery (aOR 1.56).

CONCLUSIONS: The opioid epidemic is a serious threat to national public health, and spine surgeons must practice conscientious postoperative opioid prescribing to achieve adequate pain control. The authors' analysis illustrates that a postoperative opioid prescription of 225 MME or less is associated with improved patient satisfaction, greater improvement in physical function, and decreased opioid dependence compared with those who had > 225 MME prescribed.

Volume

38

Issue

2

First Page

242

Last Page

248

Recommended Citation

Lim S, Yeh HH, Macki M, Haider S, Hamilton T, Mansour TR, et al. [Easton R, Khalil JG, Perez-Cruet M]. Postoperative opioid prescription and patient-reported outcomes after elective spine surgery: a Michigan Spine Surgery Improvement Collaborative study. J Neurosurg Spine. 2022 Oct 7;38(2):242-248. doi: 10.3171/2022.8.SPINE22571. PMID: 36208431.

DOI

10.3171/2022.8.SPINE22571

ISSN

1547-5646

PubMed ID

36208431