Document Type
Article
Publication Date
2-8-2025
Publication Title
North American Spine Society Journal
Abstract
BACKGROUND: The United States Veteran Health Administration (VHA) cares for a substantial group of patients who are at higher risk of substance abuse in comparison to the general population. The purpose of this study was to (1) examine opioid consumption in the veteran population both pre- and postoperatively to anterior cervical discectomy and fusion (ACDF) and (2) understand the risk factors that are associated with sustained postoperative opioid use. METHODS: A retrospective database study was conducted using the Veterans Affairs Informatics and Computing Infrastructure database. Patients who underwent ACDF between 2010 and 2020 were identified and stratified into 3 groups based on their preoperative opioid usage prior to the procedure: opioid naïve, low preoperative opioid use (1-3 preoperative claims), and high preoperative opioid use ( ≥ 4 preoperative claims). Cumulative pre- and postoperative opioid usage for each patient was calculated in Morphine Milligram Equivalents (MME). RESULTS: A total of 7,894 patients were identified with 3,929 (49.7%) opioid naïve, 1,813 (23.0%) low preoperative opioid use, and 2,152 (27.3%) high opioid usage. The proportion of patients in the opioid-naïve cohort, low preoperative usage cohort, and high preoperative opioid usage cohort, that remained on opioids 1 year postoperatively was 13.1%, 31.3%, and 77.8%, respectively. At 1 year postoperatively, the median opioid MME significantly decreased pre- to postoperatively (25.0 vs. 0, p < .006). High preoperative opioid consumption was found to be the greatest risk factor for continued chronic opioid use (OR 17.1, p < .001). CONCLUSIONS: Following ACDF procedures, opioid consumption significantly decreased; however, at 1 year, over one-third of patients remained on opioid therapy. A disproportionate number of patients who remained on chronic opioid therapy had high preoperative opioid consumption. Notably, increased scrutiny and policy changes regarding opioids, which began around 2017, resulted in a significant reduction in preoperative opioid use by 2020 compared to a decade earlier.
PubMed ID
40160480
Volume
22
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Gabig, Andrew M.; Rezaii, Paymon G.; Clark, Sean C.; Delvadia, Bela P.; Lee, Olivia C.; Sherman, William F.; and Cyriac, Mathew, "Trends of opioid use following anterior cervical discectomy and fusion: A 10-year longitudinal study of the Veterans Health Administration" (2025). School of Medicine Faculty Publications. 3649.
https://digitalscholar.lsuhsc.edu/som_facpubs/3649
10.1016/j.xnsj.2025.100595
Included in
Military and Veterans Studies Commons, Surgical Procedures, Operative Commons, Therapeutics Commons