Optimizing Preoperative Chronic Pain Management in Elective... : JBJS Reviews

You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page.

Review Articles

A Narrative Review of Outcomes with Opioid and Adjuvant Pain Therapies

Arciero, Emily BS1; Coury, Josephine R. MD1; Dionne, Alexandra BS1; Reyes, Justin MS1,a; Lombardi, Joseph M. MD1; Sardar, Zeeshan M. MD1

Author Information

1The Och Spine Hospital, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York

aEmail for corresponding author: [email protected]

Investigation performed at Columbia University Medical Center/NewYork-Presbyterian Och Spine Hospital, New York, New York

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (https://links.lww.com/JBJSREV/B41).

JBJS Reviews | DOI: 10.2106/JBJS.RVW.23.00156

Metrics Abstract » Chronic preoperative opioid use negatively affects outcomes after spine surgery, with increased complications and reoperations, longer hospital stays, decreased return-to-work rates, worse patient-reported outcomes, and a higher risk of continued opioid use postoperatively. » The definition of chronic opioid use is not consistent across studies, and a more specific and consistent definition will aid in stratifying patients and understanding their risk of inferior outcomes. » Preoperative weaning periods and maximum dose thresholds are being established, which may increase the likelihood of achieving a meaningful improvement after surgery, although higher level evidence studies are needed. » Spinal cord stimulators and intrathecal drug delivery devices are increasingly used to manage chronic back pain and are equivalent or perhaps even superior to opioid treatment, although few studies exist examining how patients with these devices do after subsequent spine surgery. » Further investigation is needed to determine whether a true mechanistic explanation exists for spine-related analgesia related to spinal cord stimulators and intrathecal drug delivery devices. Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated Full Text Access for Subscribers:

You can read the full text of this article if you:

Select an optionLog InBuy ArticleSubscribeContent & PermissionsAccess through Ovid

Log In Access through Ovid Article Level Metrics