Spine最新文献

{"title":"Do Preoperative Epidural Steroid Injections Increase the Risk of Postoperative Complications Following Cervical Disc Replacement?","authors":"Zuhaad Hameed, Ved A Vengsarkar, Clare K Green, Bhavana Yalamuru, Adam L Shimer, Stephen D Lockey","doi":"10.1097/BRS.0000000000005376","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005376","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective database analysis.</p><p><strong>Objective: </strong>To determine whether any associations exist between the use of preoperative epidural steroid injections (ESIs) and postoperative complications following cervical disc replacement (CDR).</p><p><strong>Summary of background data: </strong>Preoperative ESIs are a commonly used modality for patients with cervical spine pathology. Previous studies have demonstrated cervical ESIs to be associated with higher complications after anterior cervical discectomy and fusion. To date, there is little known about the impact of cervical ESIs on the postoperative outcomes after CDR.</p><p><strong>Methods: </strong>The PearlDiver Database was queried for patients who underwent CDR between 2010 and 2022. Patients were stratified based on ESI use within 90 days prior to surgery. Propensity-score matching was used to account for baseline differences. Outcomes collected included 90-day complications, readmissions, and 2-year reoperation rates.</p><p><strong>Results: </strong>Patients receiving preoperative ESI had significantly higher rates of postoperative urinary tract infections (3.2% vs. 1.6%, OR=2.03, P<0.001). Recurrent radiculopathy was more prevalent in the ESI group (63.1% vs. 16.1%, OR=9.02, P<0.001), and ESI patients experienced a higher rate of revision surgery within 2 years compared to control patients (7.8% vs. 2.4%, OR=3.50, P<0.001). Additionally, ESI patients experienced higher rates of emergency department visits at 30 days (6.2% vs. 4.8%, OR=1.31, P=0.020), and readmission rates at both 30 days (2.8% vs. 1.1%, OR=2.52, P<0.001) and 90 days (9.7% vs. 2.0%, OR=5.29, P<0.001) postoperatively.</p><p><strong>Conclusion: </strong>Preoperative ESI within 90 days of surgery is associated with increased rates of postoperative complications, readmissions, and reoperation following CDR.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Intraoperative Hemodynamic Monitoring Decreases In-hospital Costs.","authors":"Leah Y Carreon, Steven D Glassman, Desiree Chappell, Mladen Djurasovic, Justin Mathew, Timothy Ward, Jeffrey L Gum","doi":"10.1097/BRS.0000000000005373","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005373","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective comparative cohort.</p><p><strong>Objective: </strong>To determine if the use of Predictive Hemodynamic Monitoring (PHM) leads to cost savaings for the institution.</p><p><strong>Summary of background data: </strong>A recent study showed that the use of PHM during posterior spine fusions decreases episodes of intra-operative hypotension, complications and length of stay.</p><p><strong>Methods: </strong>Adults undergoing elective multi-level instrumented posterior thoracolumbar fusion with PHM (N=47) were identified and propensity-matched to those in whom it was not (Non-PHM, N=70). Demographic and surgical data, intra-op and post-op hemodynamic and fluid management data and complications were collected. Cost data were stratified into Surgery (admission to recovery room discharge), Post-operative (recovery room to hospital discharge) and 90-days after discharge.</p><p><strong>Results: </strong>Propensity matching produced 41 patients each in the PHM and Non-PHM groups. The PHM group had a shorter duration of intra-op hypotension (6.6 min vs. 13.33 min, P=0.044); and shorter duration of intra-op hypertension (2.4 min vs. 6.7 min, P=0.029) compared to the Non-PHM group. Volume of colloids, fluids and blood products transfused intra- and post-operatively were similar.There was a lower but not statistically significant number of complications per patient in the PHM compared to the Non-PHM group (P=0.053) and a statistically significant shorter length of stay (4.5 vs. 7.0, P=0.011). Surgery costs were similar between the two groups ($41,482 vs. $42,264, P=0.853). Post-operative costs were lower in the PHM ($2,757) compared to the Non-PHM group ($5,339, P=0.001), driven mostly by Room & Board ($1,639 vs. $3,597, P<0.001). Pharmacy ($248 vs. $429, P=0.007), Labs ($108 vs. $178, P=0.020) and Therapy ($448 vs. $877, P=0.003). Costs in the 90 days after discharge were similar between the two groups ($593 vs. $438, P=0.574).</p><p><strong>Conclusions: </strong>The use of PHM decreases intra-operative hemodynamic instability. This may be associated with a lower incidence of complications, decreased length of stay and a potential cost savings of $2,500 per case.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Biological Aging and Inflammatory Profiles in Adult Spinal Deformity Patients Between Japan and the United States: A Correlative Study.","authors":"Mitsuru Yagi, Naobumi Hosogane, Christopher P Ames, Michael P Kelly, Justin S Smith, Christopher I Shaffrey, Frank J Schwab, Virginie Lafage, Shay Bess","doi":"10.1097/BRS.0000000000005370","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005370","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective matched cohort study.</p><p><strong>Objective: </strong>Understanding biological aging in adult spinal deformity (ASD) across different populations offers insights into its impact on aging and potential interventions.</p><p><strong>Summary of background data: </strong>ASD significantly impacts physiological health and may accelerate biological aging. Understanding biological aging in ASDs across different populations offers insights into ASD's impact on aging and potential interventions.</p><p><strong>Materials and methods: </strong>ASDs and norms from Japan (JP) and the U.S. (US) were included. The US norm consisted of 8,751 adults from NHNES 2017-20; the JP norm comprised 10,205 adults from health check-ups between 2020-23. Age- and gender-matched norm cohorts of 6,584 pairs (JP vs. US) were established (age: 55±13 vs. 55±14 y; female: 49 vs. 50%). ASD were age-, race- and gender-matched to norm individuals in JP (159 pairs) and the US (132 pairs). Additionally, 81 pairs of ASDs from JP and US were selected for cross-country comparisons.</p><p><strong>Results: </strong>The JP was biologically younger than the US (PhenoAge: mean difference [MD] -6.5±0.3 y; P<0.01). When comparing JP and US Asians, the JP remained biologically younger (MD: -3.1±0.7 y; P<0.01), suggesting lifestyle differences. JP ASDs were biologically older than their norms (MD: 4.2±1.7 y; P=0.02), indicating accelerated aging. However, no significant difference was observed between ASDs and the norms in the US. No significant difference in PhenoAge was found between JP and US ASDs (57.9±18.4 vs. 59.6±17.6 y; P=0.56). ASDs in both countries exhibited higher systemic inflammation, with US ASDs showing particularly elevated CRP levels (US ASD vs. norm: 2.8±8.5 vs. 0.4±0.8 mg/dL; P<0.01; JP: 0.5±1.3 vs. 0.2±0.4 mg/dL; P<0.01).</p><p><strong>Conclusions: </strong>JP are biologically younger than their US counterparts, potentially due to lifestyle factors. JP ASDs exhibit accelerated biological aging compared to the norm cohort, highlighting the impact of ASD on aging. Elevated systemic inflammation in ASDs underscores the importance of managing inflammatory processes.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor on \"Long-Term Bladder, Bowel, and Ambulatory Function after Sacrectomy Surgery\".","authors":"Chengri Liu, Qingyu Xu, Yanqun Liu","doi":"10.1097/BRS.0000000000005374","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005374","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Minimally Invasive Transforaminal Lumbar Interbody Fusion: Comparison of Pre-, Partial-, and Full-navigation in a 15-year Cohort.","authors":"Yi-Hsuan Kuo, Chao-Hung Kuo, Tsung-Hsi Tu, Hsuan-Kan Chang, Chin-Chu Ko, Chih-Chang Chang, Li-Yu Fay, Wen-Cheng Huang, Jau-Ching Wu","doi":"10.1097/BRS.0000000000005249","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005249","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective observation.</p><p><strong>Objective: </strong>To analyze the evolution and impact of navigation technology in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).</p><p><strong>Summary of background data: </strong>While navigated pedicle screw placement improves accuracy, reduces blood loss, and decreases radiation exposure for surgeons, longer operation times have also been reported.</p><p><strong>Methods: </strong>All patients who underwent MIS-TLIF between 2008 and 2022 were included. Physiological measures, including surgical disc levels, operation time, estimated blood loss, and the incidence of screw revision due to malposition, debridement, surgery for adjacent segment disease, or implant failure, were compared. Patients were divided into two groups: \"no navigation\" (fluoroscopic guidance) and \"navigation\" (from navigated screw placement to full navigation including decompression and interbody grafting, eliminating fluoroscopy). Year groups were further analyzed: 2008-2011 (no navigation), 2012-2015 (no navigation), 2016-2019 (navigation for screw placement), and 2020-2022 (total navigation).</p><p><strong>Results: </strong>A total of 823 patients (427 \"no navigation\" vs. 396 \"navigation\") were included. In one-disc-level non-navigated MIS-TLIF, operation time decreased across the years (266.0±63.9 [2008-2011] vs. 215.5±57.3 [2012-2015] vs. 191.7±41.8 [2016-2019] minutes, P<0.001). For navigated screw placement (2016-2019), navigation prolonged the duration of one-disc-level MIS-TLIF (241.7±106.2 vs. 191.7±41.8 min, P<0.001) but not in two-disc-level MIS-TLIF (293.1±74.1 vs. 302.8±69.8 min, P=0.544). Under total navigation (2020-2022), navigation barely affected the operation time in one-disc-level MIS-TLIF (194.8±54.6 vs. 190.2±47.4 min, P=0.663) and even accelerated two-disc-level surgery (279.9±64.1 vs. 362.7±80.7 min, P=0.002). There were no differences in blood loss and re-operation rate. The adaptation of navigation also facilitated long-segment (3- and 4-disc-level) cases, and the number gradually increased over years, though not sufficient for analyses.</p><p><strong>Conclusions: </strong>Spinal navigation accelerated MIS-TLIF in multi (2 or more) disc-level cases after establishment and evolved towards a fluoro-less workflow. Navigation expanded MIS-TLIF to multi-level cases at similarly low complications rates.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Sagittal Balance Influence Microsurgical Results for Spinal Stenosis? a prospective 4 years follow-up.","authors":"Malte Dinkelbach, Anton Früh, Jörg Franke, Kimberly Ohm, Florian Pöhlmann, Nils Hecht, Peter Vajkoczy, Simon Bayerl","doi":"10.1097/BRS.0000000000005195","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005195","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Study.</p><p><strong>Objective: </strong>Lumbar spinal stenosis (LSS) is known as one of the most frequent causes for spinal surgery. Since sagittal balance (SB) has drawn scientific attention in recent years, questions have been raised, whether there is a need to restore SB for best clinical outcome in every spinal surgery. This study evaluated the influence of SB on clinical outcome of patients with LSS in a long-term follow-up of more than 4 years.</p><p><strong>Summary of background data: </strong>Results of short-term follow-up did not show any association between clinical outcome and the degree of sagittal imbalance in patients with LSS, who received microsurgical decompression alone. Data concerning the long-term influence of sagittal balance are lacking.</p><p><strong>Methods: </strong>136 patients were included and received a 1-year follow-up. 72 subjects underwent additional long-term follow up (51 months). The patients received preoperative and follow-up long-standing spinal radiographs. Patients were assigned to one of three groups, according to their SB (normal-balance(NB), minor-loss-of-balance(miIB), major-loss-of-balance(maIB)). Clinical outcome parameters were determined by evaluating Roland-and-Morris-disability-questionnaire, Oswestry-Disability-Index, Odom's-criteria, SF-36-score, visual-analogue-scales for pain and the walking distance.</p><p><strong>Results: </strong>Long-term follow-up showed a significant improvement of clinical outcome parameters independently of their sagittal balance(∆ODI_NB= -23,0±18,9; ∆ODI_miIB=- 26,9 ± 21,6; ∆ODI_maIB= -21,6±25,1). There was no significant difference between the three groups in pain, disability and quality-of-life. The miIB group benefitted most concerning walking distance. A relevant change concerning the sagittal balance was not detected at 4 years after surgery.</p><p><strong>Conclusions: </strong>SB does not influence the long-term clinical outcome in patients with symptomatic LSS after microsurgical decompression. Patients without obvious instability benefit significantly from microsurgery, regardless of their preoperative global sagittal balance. The initial pathological SB in patients with LSS appears to represent true structural changes of the spine, rather than a pseudo-imbalance due to a compensatory mechanism in order to relieve claudication.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to editor on \"Dual Sustained-Release BMP7-Nanoparticle Hydrogel Scaffolds for Enhanced BMSC Neuronal Differentiation and Spinal Cord Injury Repair\".","authors":"Long Yu, Qingyu Xu","doi":"10.1097/BRS.0000000000005371","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005371","url":null,"abstract":"","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Associated with Revision Microdiscectomy or Subsequent Spinal Fusion within 2 Years of Index Lumbar Microdiscectomy.","authors":"Dallas E Kramer, Tyson S Barrett, Charlotte Drury-Gworek, Keith LeJeune, Boyle C Cheng, Praveer Vyas, Kevin Walsh, Edward Richard Prostko, Daniel T Altman, Lara Massie","doi":"10.1097/BRS.0000000000005302","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005302","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review of insurance claims and electronic medical records of a major blended health organization in the eastern United States.</p><p><strong>Objective: </strong>Primary objective was to report rates of revision microdiscectomy and fusion within 2 years of index lumbar microdiscectomy. Secondary objectives were to identify patient characteristics and comorbidities predictive for revision surgeries.</p><p><strong>Summary of background information: </strong>Incidence of disc reherniation following lumbar microdiscectomy ranges from 3% to 18%. Although rates of revision microdiscectomy are well reported, rates of fusion after index microdiscectomy and risk factors for subsequent fusion beyond history of prior discectomy warrants further investigation.</p><p><strong>Methods: </strong>Retrospective review of health insurance claims data for index lumbar microdiscectomy between January 2016, and December 2019. Rates of revision microdiscectomy and fusion within 2 years were reported, and cohort demographics and Charlson Comorbidity Index (CCI) comorbidities were analyzed using Pearson's chi-square analyses and Fisher exact tests. Time-to-event modeling and multivariate Cox proportional hazards regression assessed for predictors of revision surgery.</p><p><strong>Results: </strong>The full sample consisted of 8,158 members. The rate of revision microdiscectomy was 3.5% within 1 year and 5.5% within 2 years of index surgery. The rate of fusion was 2.9% within 1 year and 6.6% within 2 years of index surgery. Age 40-59 (P<0.001), female sex (P=0.024), and presence of ≥ 1 CCI comorbidities (P<0.001) were significantly associated with time-to-fusion but not revision microdiscectomy. Increasing CCI score was associated with a significantly greater likelihood of need for fusion (CCI=1, HR 1.35, P=0.045; CCI=2, HR 1.85, P<0.001; CCI ≥ 3, HR 2.47, P<0.001).</p><p><strong>Conclusion: </strong>Rates of revision microdiscectomy and fusion within 2 years of index lumbar microdiscectomy were 5.5% and 6.6%, respectively. Age 40-59 years, female sex, and having ≥ 1 CCI comorbidity, were significantly predictive of time-to-fusion but not revision microdiscectomy. Having at least one comorbidity increased the likelihood of fusion by 80%.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does BMI Impact Spinopelvic Alignment after Lumbar Fusion Surgery?","authors":"Jonathan Dalton, Ali Farooqi, Teeto Ezeonu, Robert J Oris, Rachel Huang, Rajkishen Narayanan, Ruchir Nanavanti, Molly Milano, Christian McCormick, Mark F Kurd, Ian David Kaye, Thomas D Cha, John J Mangan, Jose Canseco, Alan Hilibrand, Alexander Vaccaro, Gregory Schroeder, Christopher Kepler","doi":"10.1097/BRS.0000000000005369","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005369","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>Evaluating the impact of elevated BMI on perioperative sagittal alignment parameters amongst patients undergoing single-level lumbar fusion.</p><p><strong>Summary of background data: </strong>Sagittal malalignment affects postoperative outcomes after fusion for spine deformity. It is unclear what role elevated BMI plays in attaining and maintaining proper spinopelvic parameters postoperatively.</p><p><strong>Methods: </strong>Adult patients who underwent one-level lumbar fusion (2010-2019) with preoperative, immediate and 2-3 year postoperative lateral lumbar radiographs were retrospectively identified. Spinopelvic parameters (lumbar lordosis (LL), segmental lordosis (SL), posterior disc height (DH), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI)) were collected. Patients were dichotomized based on PT and PI-LL cutoffs indicative of spinopelvic instability (PT>20° and PI-LL>10). Patients were classified based on BMI (normal:18.5-24.9; overweight:25-29.9; obese≥30). Demographic and surgical outcome data were compared between groups. Multivariate was utilized to assess independent predictors of PI-LL mismatch>10° at 2-3 years follow-up.</p><p><strong>Results: </strong>832 patients were included-132 normal BMI, 267 overweight, and 433 obese. As BMI categories increased (normal vs. overweight vs. obese) female percentage decreased (69.7% vs. 46.1% vs. 48.5%, P<0.001), and Elixhauser comorbidity index increased (ECI) (0.99±1.04 vs. 1.15±1.14 vs. 1.60±1.29, P<0.001). At baseline, patients with greater BMI had greater PT (21.5°±8.05° vs. 22.8°±8.19° vs. 24.0°±9.24°, P=0.025) and were more likely to have PT>20° (59.1% vs. 68.7% vs. 71.2%, P=0.036). Logistic regression found BMI (OR: 1.06, CI: 1.01-1.12, P=0.024) and preoperative PI-LL mismatch (OR: 1.17, CI: 1.14-1.21, P<0.001) to be independent predictors of PI-LL>10° at 2-3 years postoperatively.</p><p><strong>Conclusion: </strong>This study indicates that increasing BMI is associated with increasing incidence of male sex, comorbidity burden, and worse preoperative sagittal balance. Additionally, increasing BMI was independently predictive of failure to attain ideal, long-term postoperative PI-LL mismatch.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study.","authors":"Andreas K Andresen, Leah Y Carreon, Rune Bech, Carsten R Bjarkam, Carsten Bruun, Jon Caspersen, Kjeld Dons, Louise Møller Jørgensen, Mikkel Rasmussen, Michael Nielsen, Troels Hafeldt Nielsen, Casper Pedersen, Kresten Rickers, Rikke Rousing, Simon Toftgaard Skov, Mikkel Østerheden Andersen","doi":"10.1097/BRS.0000000000005241","DOIUrl":"https://doi.org/10.1097/BRS.0000000000005241","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The purpose of the current study is to describe long-term opioid use following lumbar spine surgery and, to investigate risk factors associated with prolonged use of opioids in patients undergoing spine surgery to treat chronic pain.</p><p><strong>Summary of background data: </strong>During the last decade, the use of opioids in management of non-malignant pain has been a topic of interest to surgeons and politicians worldwide with reference to the \"opioid epidemic\" in the United States. Although WHO guidelines advice against use of opioids to treat chronic low back pain in patients with degenerative spine orders, such therapy is still administered to vast numbers of patients all over the world.</p><p><strong>Materials and methods: </strong>This is an observational study of 14,082 patients based on a nationwide database of spine surgeries (DaneSpine) during the period 2016-2022. We included patients who underwent lumbar spine surgery to treat spinal stenosis, spondylolisthesis and disc herniation. Statistical analysis included descriptive statistics and Relative Risk analysis for factors associated with one-year postoperative opioid use.</p><p><strong>Results: </strong>We had available data on pre- and postoperative use of pain medicine and opioids on 14.082 patients who underwent spine surgery due to spinal stenosis (n=7.932), disc herniation (n=4.573) and spondylolisthesis (n=1.577). 36% of patients were on prescription opioids before surgery, as compared to 17% of patients at 1-year follow-up after surgery. (P<0.001).Overall, patients with preoperative opioid use had an increased relative risk (RR) of 4.70 (P=0.002) of being prolonged opioid users in all patient groups combined. Modifiable risk factors for prolonged postoperative opioid use included pain duration, body mass index and smoking.</p><p><strong>Conclusion: </strong>While opioid use is diminished overall during the seven-year study period, and most patients came of opioids after surgery, we found that preoperative opioid use was the strongest predictor for prolonged postoperative use.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}