Introduction: Opioid epidemic is of prodigious concern throughout the United States.
The aim of our study was to identify factors predictive of opioid dependency following surgery for Degenerative Scoliosis (DSc).
Methods: In this retrospective study, data was extracted using national Market Scan database (2000-2012). Opioid dependency was defined as continued opioid use or >10 opioid prescriptions for one year either prior to or 3-15 months following the procedure. Comparisons of outcomes were performed using non-parametric 2-group tests and generalized regression models.
Results: A cohort of 973 patients was identified from the database. Median age was 60years (51-70 years) and 66% (n=644) of patients were females. Only 12.9% (n=125) of patients had Elixhauser 3+ comorbidity score. 20% (n=199) of patients were identified to have opioid dependency within 12 months prior to surgery and 16.0% (n=156) were identified to have opioid dependency within 3-15 months after the procedure. Patients were 1.7 times likely to become opioid independent than opioid dependent (10.17% vs. 5.76%, p =0.0006) following surgery for DSc. Opioid dependency prior to the surgery was the only variable identified as a predictor of post-surgery opioid dependency in this cohort (OR: 13.18, CI: 8.89-19.54). Age, gender, comorbidities and type of insurance had no effect on opioid dependency following surgery for DSc.
Conclusions: Surgery for Degenerative Scoliosis was associated with increased likelihood of opioid independency than dependency in the post-operative period. Prior opioid dependency was associated with increased risk of opioid dependency following surgery for DSc.
Patient Care: By identifying the risk factors predictive of opioid dependency in patients with DSc, physicians may be able to assist in taking necessary steps in controlling this opioid epidemic.
Learning Objectives: By the conclusion of this session, participants should be able to 1) Identify the factors associated with opioid dependency following surgery for degenerative Scoliosis. 2) Describe the impact of surgery on opioid dependency in patients with DSc.