Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users

Reisener Marie-Jacqueline; Hughes Alexander P.; Schadler Paul; Forman Alexa; Sax Oliver C.; Shue Jennifer; Cammisa Frank P.; Sama Andrew A.; Girardi Federico P.; Mancuso Carol A.

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저자정보: Reisener Marie-Jacqueline (Hospital for Special Surgery New York NY USA) Hughes Alexander P. (Hospital for Special Surgery New York NY USA) Schadler Paul (Hospital for Special Surgery New York NY USA) Forman Alexa (Hospital for Special Surgery New York NY USA) Sax Oliver C. (Hospital for Special Surgery New York NY USA) Shue Jennifer (Hospital for Special Surgery New York NY USA) Cammisa Frank P. (Hospital for Special Surgery New York NY USA) Sama Andrew A. (Hospital for Special Surgery New York NY USA) Girardi Federico P. (Hospital for Special Surgery New York NY USA) Mancuso Carol A. (Hospital for Special Surgery New York NY USA)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.5

발행연도: 2020.1

수록면: 663 - 672 (10page)

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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, “reater 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.

#Expectations #Lumbar surgery #Opioids #Lower-back pain

참고문헌 (30)

참고문헌 신청

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