With opioid dependency reaching epidemic proportions in the United States, it’s no wonder that spine surgeons and patients alike are concerned. Patients suffering from back pain are often prescribed the powerful painkillers by well-meaning physicians long before they ever consult with a specialist, and physicians need to weigh the best approach to pain management after surgery for those who are already addicted.
In light of this issue, a new study conducted by researchers from the University of Louisiana represents very good news: researchers from the school and hospital’s Department of Neurological Surgery have conducted extensive analysis of back surgery patients and have found that those who have had surgery for the treatment of degenerative spondylolisthesis are at a reduced risk for opioid dependency as compared to their level of vulnerability before the procedure.
The research was led by Mayur Sharma, M.D., M. Ch., a resident at the facility, and was published in the Journal of Neurosurgery: Spine. The research was comprised of a retrospective review of the medical records of nearly 11,000 patients who underwent surgery for degenerative spondylolisthesis between 2000 and 2012.
Spondylolisthesis affects roughly 5% of people in the United States. It has several causes, including the degeneration that comes with age, spinal trauma, and on rare occasions can be caused by diseases like tuberculosis or cancer. It is characterized by a vertebra slipping out of its normal position, and usually affects the lower back. It leads to back pain, changes in posture, difficulty walking, and pain in the legs. It can also lead to abnormal curves in the spine and can impinge upon the nerves, leading to numbness or tingling in the arms or legs. Most patients are treated with decompression and fusion surgery, and the researchers determined that almost 15 percent had been dependent upon opioid pain medications with a one-year period prior to their surgery. However, after the surgery that dependence level dropped to less than 10 percent.
Speaking of the group’s findings, Sharma said, “Spine surgery patients deal with an immense amount of pain both before and after surgery. Opioids are used to manage that pain. Patients have been abusively using opioids for pain resulting in the recently declared national opioid crisis. Our work indicates that surgery for degenerative spondylolisthesis is associated with a reduced risk of opioid dependence.”
In addition to determining whether surgery had an impact on the level of opioid dependency upon spinal surgery patients, Sharma’s group also focused on the characteristics of spine surgery patients that were most at risk for dependency.
They found that patients who were younger were at higher risk, as well as those who had a previous history of opioid dependence. This suggests that spine surgery patients can use these two factors in assessing their use of pain medications.