Breaking News
November 21, 2018 - Disrupting reproduction strategy of disease-causing parasites could help fight malaria
November 20, 2018 - ACAAI: Almost 2 Percent of Children Have Milk Allergy
November 20, 2018 - Congenital anomalies of kidney and urinary tract – Genetics Home Reference
November 20, 2018 - Can video games improve the health of older adults with schizophrenia?
November 20, 2018 - Can flicking a molecular switch restore the aging immune system’s competence?
November 20, 2018 - Restek launches new Oregon cannabis pesticide standards
November 20, 2018 - Health sector coalition urges Government to safeguard patients in future UK-EU relationship
November 20, 2018 - Study evaluates second-hand marijuana smoke exposure among children
November 20, 2018 - Scientists identify three genes responsible for recurrent molar pregnancies
November 20, 2018 - Researchers identify multisystem disorder caused by bi-allelic variants in CCDC47 gene
November 20, 2018 - Dining Out With Allergies Is Tough, But These Steps Can Help
November 20, 2018 - Breastfeeding protects infants from antibiotic-resistant bacteria
November 20, 2018 - AI matched, outperformed radiologists in screening X-rays for certain diseases | News Center
November 20, 2018 - Adolescents increasingly choose marijuana over cigarettes, alcohol
November 20, 2018 - World’s first medical imaging scanner produces diagnostic scan of the whole human body
November 20, 2018 - Cytocybernetics receives NIMH award to move into neuronal drug development
November 20, 2018 - Recreational drug may help people regain trust in others
November 20, 2018 - Researchers identify gene vital for post-stroke recovery
November 20, 2018 - Scientists identify novel target for neuron regeneration, functional recovery in spinal cord injury
November 20, 2018 - Potential new therapeutic approach developed for synovial sarcoma
November 20, 2018 - Skeletal imitation reveals how bones grow atom-by-atom
November 20, 2018 - Autism behaviors show unique brain network fingerprints in infants
November 20, 2018 - Location matters for inflammation clearance
November 20, 2018 - Towards finding a druggable cancer target
November 20, 2018 - Ultragenyx Announces Intent to Submit New Drug Application to U.S. FDA for UX007 for the Treatment of Long-chain Fatty Acid Oxidation Disorders in Mid-2019
November 20, 2018 - Cooling ‘brains on fire’ to treat Parkinson’s
November 20, 2018 - Less pollution could increase the average lifespan of Copenhageners by an entire year in 2040
November 20, 2018 - Abramson Cancer Center becomes the 28th member institution of National Comprehensive Cancer Network
November 20, 2018 - The plug and play time-resolved spectrometer from PicoQuant
November 20, 2018 - Breakthrough technology offers new hope to people with glaucoma, retinitis and macular degeneration
November 20, 2018 - New report highlights key focus areas to help cancer screening realize its full potential
November 20, 2018 - International experts to discuss strategies to maintain spatial orientation in old age
November 20, 2018 - Low-protein, high-carb diet may promote healthy brain ageing
November 20, 2018 - Scientists discover new inhibitor that decreases lung inflammation
November 20, 2018 - Participation project calls for relaxing research ban on germline interventions
November 20, 2018 - Karyopharm’s Selinexor Receives Fast Track Designation from FDA for the Treatment of Patients with Relapsed or Refractory Diffuse Large B-cell Lymphoma
November 20, 2018 - Arthritis by the Numbers: Book of Trusted Facts & Figures
November 20, 2018 - Drug homing method helps rethink Parkinson’s
November 20, 2018 - AHF commends the passage of global AIDS funding in the House, calls for swift approval
November 20, 2018 - The search for new psychiatric disorder treatments
November 20, 2018 - New research offers hope for simpler way to diagnose and treat cancer
November 20, 2018 - Study sheds light on the infection mechanism of influenza virus
November 20, 2018 - Storage failures of eggs and embryos gain a new perspective
November 20, 2018 - Buyers of short-term health plans: Wise or shortsighted?
November 20, 2018 - Study indicates that frogs in virus-exposed groups breed at young age
November 20, 2018 - FDA Alerts Health Care Professionals and Patients Not To Use Sterile Drug Products from Pharm D Solutions
November 20, 2018 - Asthma may contribute to childhood obesity epidemic
November 20, 2018 - Live probiotics can change existing gut flora and alter immune response
November 20, 2018 - Researchers to explore the enigmatic role of unstructured protein in regulating circadian function
November 20, 2018 - Many patients with adenomas do not receive colonoscopy within recommended time frame
November 20, 2018 - Drug used to treat PTSD does not reduce suicidal thinking, may worsen nightmares and insomnia
November 20, 2018 - In-person social contact may offer protection against depression and PTSD symptoms
November 20, 2018 - Routine HCV testing in correctional facilities can best identify and treat disease, say researchers
November 20, 2018 - Molecular DNA analysis could facilitate more accurate prognosis, treatment of aggressive brain tumors
November 20, 2018 - Breast Cancer Recurrence Rate Not Up With Autologous Fat Transfer
November 20, 2018 - Beta 2 Microglobulin (B2M) Tumor Marker Test: MedlinePlus Lab Test Information
November 20, 2018 - Could bariatric surgery make men more virile?
November 20, 2018 - Urine test to check if patients take their medications will save the NHS money, say researchers
November 20, 2018 - Study reveals impact of residual inflammatory risk on clinical outcomes after PCI
November 20, 2018 - RNAi therapy shown to alleviate preeclampsia
November 20, 2018 - Replacement of dysfunctional microglia has therapeutic potential for neurodegenerative diseases
November 20, 2018 - Forming 3D Neuronal Models of the Brain
November 20, 2018 - Shoulder ultrasounds could be used to predict diabetes
November 20, 2018 - SGLT2 Inhibitors for Diabetes Linked to Increased Risk for Amputation
November 20, 2018 - Stem cell transplant cements Arizona men’s father-son bond
November 20, 2018 - Scientists try to develop portable systems that can quickly produce biologics on demand
November 20, 2018 - Automating Data Capture and Image Analysis in Continuous Experiments
November 20, 2018 - New drug shows promise for treating people with peanut allergy
November 20, 2018 - Researchers develop novel mouse model to study immunomodulatory therapies
November 20, 2018 - “Britain must not go backward on antibiotic controls to appease US trade deals” – Jim Moseley, CEO of Red Tractor
November 20, 2018 - Widespread errors in ‘proofreading’ cause inherited blindness
November 20, 2018 - Reaping the benefits of living longer
November 20, 2018 - New Program Hopes to Make Early Detection and Treatment of ALS a Reality
November 19, 2018 - Artificial bone-like substance mimics the way real bone grows at atomic level
November 19, 2018 - FDA Grants Orphan Drug Designation To RGX-181 Gene Therapy For The Treatment Of CLN2 Form Of Batten Disease
November 19, 2018 - Systemic mastocytosis – Genetics Home Reference
November 19, 2018 - Eye trauma secondary to falls in older adults increasing
November 19, 2018 - Empowering women in India to improve their health: A Q&A
November 19, 2018 - Researchers have trained a computer to analyze breast cancer images and classify tumors
November 19, 2018 - New glucose binding molecule could be key to better metabolic control for diabetics
Researchers examine risk factors for opioid dependence in patients undergoing surgery for DS

Researchers examine risk factors for opioid dependence in patients undergoing surgery for DS

image_pdfDownload PDFimage_print

Researchers investigated risk factors for the development of opioid dependence in patients undergoing surgery for degenerative spondylolisthesis (DS). They found that, overall, patients were more likely to have a dependency on opioid medications before surgery than afterward. This finding and more appear in a new article published today in the Journal of Neurosurgery: Spine: “Factors predicting opioid dependence in patients undergoing surgery for degenerative spondylolisthesis: analysis from the MarketScan databases” by Mayur Sharma, MD, MCh, and colleagues (https://thejns.org/doi/full/10.3171/2018.1.SPINE171258).

A cursory glance at headlines from news sources confirms the fact that the United States is in the midst of an opioid epidemic. And it can be deadly. In 2015, opioid overdose was cited as a cause of more than 33,000 deaths. A large proportion of opioid addiction can be traced back to the misuse of physician-prescribed medications initially provided for the management of acute or chronic pain.

A common site of pain is in the lower back. Approximately 80% of adults experience low back pain at some time during their lives. In fact, low back pain has been cited as the single leading cause of disability.

In this article, the authors set out to identify what effect on opioid dependence surgery may have when used to treat patients with degenerative spondylolisthesis (DS), the forward slippage of a vertebra onto the vertebra beneath it. DS usually occurs in the lumbar spine and is due to a weakness in bones, joints, and ligaments that accompanies the aging process. Symptoms include pain in the lower back and legs, leg fatigue, muscle spasms, and irregular gait. Most of the time DS can be treated without surgery; however, surgery is indicated if there is progressive neurological damage or the patient’s pain is disabling and does not respond adequately to nonsurgical treatment.

For their analysis, the authors defined indicators of opioid dependence as follows: continued

opioid use, more than 10 opioid prescriptions, or either a diagnosis of opioid dependence disorder or a prescription for treating opioid dependence disorder during the period of 1 year before or 3 to 15 months after surgery.

The authors extracted de-identified data from the MarketScan databases on 10,708 patients who had undergone surgery for DS. The median age of these patients was 61 years (interquartile range: 54 to 69 years). Sixty-five percent of the patients were women. In most cases (94%), the surgery was decompression with fusion, and in 76% of patients surgery involved multiple vertebrae. Many patients (54%) had one or more comorbidities. The majority of patients had commercial health insurance (61% as opposed to 35% with Medicare).

The authors were particularly interested in evaluating opioid dependence after surgery for DS, but they did examine preoperative opioid dependence to identify new cases of dependency. The authors identified a dependency on opioid medications in 15% (1,591) of the patients with DS before surgery. Between 3 and 15 months after surgery, however, the percentage of patients with a dependency on opioids was 10% (1,060).

After evaluating the impact of surgery, patient age and sex, comorbidities, and type of medical insurance held by the patients, the authors determined the following applied to patients who underwent surgery to treat DS:

  • There was an association between surgical decompression with fusion and a decreased risk of postoperative opioid dependence. In this study, the opioid dependence was reduced by 5% after surgery for DS.
  • Preoperative opioid dependence was associated with an increased risk of postoperative opioid dependence.
  • Increased patient age was associated with a decreased risk of postoperative opioid dependence.
  • Following surgery for DS, these patients were twice as likely to become opioid independent than they were to become opioid dependent.

When asked to summarize the findings of the study. Dr. Sharma said, “Decompression and fusion for DS is associated with reduced risk of opioid dependency.”

Tagged with:

About author

Related Articles