Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
Study Design Matched cohort study. Purpose To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids. Overview of Literature Chronic opioid use is common among lumbar-spine surgery patients. The dec...
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doaj-43a0334f1e0540a59e83bbf7b665252d2020-11-25T04:09:16ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462020-10-0114566367210.31616/asj.2020.01141241Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-UsersMarie-Jacqueline Reisener0Alexander P. Hughes1Paul Schadler2Alexa Forman3Oliver C. Sax4Jennifer Shue5Frank P. Cammisa6Andrew A. Sama7Federico P. Girardi8Carol A. Mancuso9 Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA Department of Medicine, Hospital for Special Surgery, New York, NY, USAStudy Design Matched cohort study. Purpose To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids. Overview of Literature Chronic opioid use is common among lumbar-spine surgery patients. The decision to undergo elective lumbar surgery is influenced by the expected surgery outcomes. However, the effects of opioids on patients’ expectations of lumbar surgery outcomes remain to be rigorously assessed. Methods A total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0–100) based on the number of items expected and degree of improvement expected. Results The mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “greater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003). Conclusions Patient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users.http://www.asianspinejournal.org/upload/pdf/asj-2020-0114.pdfexpectationslumbar surgeryopioidslower-back pain |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marie-Jacqueline Reisener Alexander P. Hughes Paul Schadler Alexa Forman Oliver C. Sax Jennifer Shue Frank P. Cammisa Andrew A. Sama Federico P. Girardi Carol A. Mancuso |
spellingShingle |
Marie-Jacqueline Reisener Alexander P. Hughes Paul Schadler Alexa Forman Oliver C. Sax Jennifer Shue Frank P. Cammisa Andrew A. Sama Federico P. Girardi Carol A. Mancuso Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users Asian Spine Journal expectations lumbar surgery opioids lower-back pain |
author_facet |
Marie-Jacqueline Reisener Alexander P. Hughes Paul Schadler Alexa Forman Oliver C. Sax Jennifer Shue Frank P. Cammisa Andrew A. Sama Federico P. Girardi Carol A. Mancuso |
author_sort |
Marie-Jacqueline Reisener |
title |
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users |
title_short |
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users |
title_full |
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users |
title_fullStr |
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users |
title_full_unstemmed |
Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users |
title_sort |
expectations of lumbar surgery outcomes among opioid users compared with non-users |
publisher |
Korean Spine Society |
series |
Asian Spine Journal |
issn |
1976-1902 1976-7846 |
publishDate |
2020-10-01 |
description |
Study Design Matched cohort study. Purpose To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids. Overview of Literature Chronic opioid use is common among lumbar-spine surgery patients. The decision to undergo elective lumbar surgery is influenced by the expected surgery outcomes. However, the effects of opioids on patients’ expectations of lumbar surgery outcomes remain to be rigorously assessed. Methods A total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0–100) based on the number of items expected and degree of improvement expected. Results The mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “greater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003). Conclusions Patient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users. |
topic |
expectations lumbar surgery opioids lower-back pain |
url |
http://www.asianspinejournal.org/upload/pdf/asj-2020-0114.pdf |
work_keys_str_mv |
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