Opioid Utilization Following Lumbar Arthrodesis

Trends and Factors Associated With Long-Term Use

Piyush Kalakoti, MD; Nathan R. Hendrickson, MD; Nicholas A. Bedard, MD; Andrew J. Pugely, MD


Spine. 2018;43(17):1208-1216. 

In This Article


Approximately one-third patients used opioids before lumbar arthrodesis. Postoperative opioid use fell dramatically during the first 3 months in ON patients, but nearly half of the pre-op OUs will remain on narcotics at 1 year after lumbar arthrodesis. Preoperative narcotic consumption, comorbidities, and drug/alcohol abuse were major drivers of prolonged postoperative narcotic use following lumbar arthrodesis. The identified risk factors and the proposed clinical utility app can be used as an adjunct to risk-stratification, patient counseling for encouraging discontinuation of presurgical narcotic use, and opioid weaning strategies. In addition, our data including the online calculator will serve as a baseline for future comparison as the national societies work to implement strategies for safer and more effective pain management control to mitigate opioid abuse.