Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users
- Author:
Marie-Jacqueline REISENER
1
;
Alexander P. HUGHES
;
Paul SCHADLER
;
Alexa FORMAN
;
Oliver C. SAX
;
Jennifer SHUE
;
Frank P. CAMMISA
;
Andrew A. SAMA
;
Federico P. GIRARDI
;
Carol A. MANCUSO
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2020;14(5):663-672
- CountryRepublic of Korea
- Language:0
-
Abstract:
Methods:A total of 77 opioid users grouped according to dose and duration (54 “higher users,” 30 “lower users”) were matched 2:1 to 154 non-opioid users based on age, sex, marital status, chiropractic care, disability, and diagnosis. All patients completed a validated 20-item Expectations Survey measuring expected improvement with regard to symptoms, function, psychological well-being, and anticipated future spine condition. “Greater expectations” was defined as a higher survey score (possible range, 0–100) based on the number of items expected and degree of improvement expected.
Results:The mean Expectations Survey scores for all opioid users and all non-users were similar (73 vs. 70, p=0.18). Scores were different, however, for lower users (79) compared with matched non-users (69, p=0.01) and compared with higher users (70, p=0.01). In multivariable analysis, “reater expectations” was independently associated with having had chiropractic care (p=0.03), being more disabled (p=0.002), and being a lower-dose opioid user (p=0.03). Compared with higher users, lower users were also more likely to expect not to need pain medications 2 years after surgery (47% vs. 83%, p=0.003).
Conclusions:Patient expectations of lumbar surgery are associated with diverse demographic and clinical variables. A lower dose and shorter duration of opioid use were associated with expecting more items and expecting more complete improvement compared with non-users. In addition, lower opioid users had greater overall expectations compared with higher users.
