Patients undergoing surgery for degenerative spondylolisthesis are more likely to have a dependency on opioid medications before surgery than afterward, according to research published in the Journal of Neurosurgery: Spine.
For the study, Mayur Sharma, MD, Cleveland Clinic, Cleveland, Ohio, and colleagues analysed a database containing 10,708 patients who had undergone surgery for degenerative spondylolisthesis. The median age of the patients was 61 years and 65.1% were women. Most patients (94%) underwent surgical decompression with fusion and in 75.9% of patients, surgery involved multiple vertebrae. Many patients (54%) had 1 or more comorbidities.
The research defined indicators of opioid dependence as continued opioid use, >10 opioid prescriptions, or either a diagnosis of opioid dependence disorder or a prescription for treating opioid dependence disorder during the period of 1 year before or 3 to 15 months after surgery.
The study identified opioid dependency in 14.85% of patients with degenerative spondylolisthesis before surgery. However, between 3 and 15 months after surgery, the percentage of patients with a dependency on opioids was only 9.9%.
After evaluating the impact of surgery, patient age and sex, comorbidities, and type of medical insurance held by the patients, the researchers determined that prior opioid dependence (odds ratio [OR] = 16.9; 95% confidence interval [CI], 14.10-18.81; P< .001) and younger age (1-year increase in age OR = 0.972; 95% CI, 0.963-0.980; P< .001) were independent predictors of opioid dependence following surgery for degenerative spondylolisthesis.
Ultimately, patients were more likely to become opioid independent than they were to become opioid dependent following surgery for degenerative spondylolisthesis (8.54% vs 3.58%; P< .001).
“Decompression and fusion for degenerative spondylolisthesis is associated with reduced risk of opioid dependency,” concluded Dr. Sharma.