期刊
GLOBAL SPINE JOURNAL
卷 -, 期 -, 页码 -出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/21925682221116825
关键词
cervical spine; myelopathy; decompression; laminectomy; laminoplasty; opioid use; pain control
A retrospective cohort study compared patterns in opioid usage between patients who undergo cervical laminectomy with instrumented fusion (LF) vs cervical laminoplasty with reconstruction (LP). The study found that LF patients had a higher rate of 6-month postoperative opioid use compared to LP patients in a single-surgeon cohort. However, findings from a national database cohort revealed no significant difference in opioid usage between LF and LP patients. Surgeons should consider distinct pain requirements associated with different procedures to prevent narcotic overuse.
Study Design Retrospective cohort study. Objective To compare patterns in opioid usage and prescriptions between patients who undergo cervical laminectomy with instrumented fusion (LF) vs cervical laminoplasty with reconstruction (LP) within single surgeon and national database cohorts. Methods We identified patients with cervical myelopathy undergoing primary LF or LP in both a single-surgeon series cohort (2004-2018) and a nationally representative cohort drawn from the IBM (R) Marketscan (R) database (2014-2016). We recorded opioid usage within 6 months of surgery and identified differences in unadjusted opioid use rates between LF and LP patients. Multivariable logistic regression was used to evaluate the association between procedure type and postoperative opioid use. Results Without adjusting for covariates, LF patients had a higher rate of 6-month opioid use in the single-surgeon cohort (15.7% vs 5.1%, P = .02). After adjusting for covariates, LF patients had higher odds of 6-month postoperative opioid use (OR 2.8 [95% CI 1.0-7.7], P = .04). In the national cohort, without adjusting for covariates, there was no significant difference in 6-month opioid use between LF and LP patients. Even after adjusting for covariates, we found no significant difference in odds. Conclusions Findings from a single-surgeon cohort reveal that LF is associated with a higher rate of 6-month opioid use than LP. This is at odds with findings from a national database cohort, which suggested that LP and LF patients have similar rates of opioid usage at 6-months postoperatively. To prevent overuse of narcotics, surgeons must consider the distinct pain requirements associated with different procedures even in treatment of the same condition.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据