Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study

Andreas K. Andresen; Leah Y. Carreon; Rune Bech; Carsten R. Bjarkam; Carsten Bruun; Jon Caspersen; Kjeld Dons; Louise Møller Jørgensen; Mikkel Rasmussen; Michael Nielsen; Troels Hafeldt Nielsen; Casper Pedersen; Kresten Rickers; Rikke Rousing; Simon Toftgaard Skov; Mikkel Østerheden Andersen

doi:10.1097/BRS.0000000000005241

Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study

Andreas K. Andresen^*, Leah Y. Carreon, Rune Bech, Carsten R. Bjarkam, Carsten Bruun, Jon Caspersen, Kjeld Dons, Louise Møller Jørgensen, Mikkel Rasmussen, Michael Nielsen, Troels Hafeldt Nielsen, Casper Pedersen, Kresten Rickers, Rikke Rousing, Simon Toftgaard Skov, Mikkel Østerheden Andersen

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

Abstract

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The purpose of the current study is to describe long-term opioid use following lumbar spine surgery and, to investigate risk factors associated with prolonged use of opioids in patients undergoing spine surgery to treat chronic pain.

SUMMARY OF BACKGROUND DATA: During the last decade, the use of opioids in management of non-malignant pain has been a topic of interest to surgeons and politicians worldwide with reference to the "opioid epidemic" in the United States. Although WHO guidelines advice against use of opioids to treat chronic low back pain in patients with degenerative spine orders, such therapy is still administered to vast numbers of patients all over the world.

MATERIALS AND METHODS: This is an observational study of 14,082 patients based on a nationwide database of spine surgeries (DaneSpine) during the period 2016-2022. We included patients who underwent lumbar spine surgery to treat spinal stenosis, spondylolisthesis and disc herniation. Statistical analysis included descriptive statistics and Relative Risk analysis for factors associated with one-year postoperative opioid use.

RESULTS: We had available data on pre- and postoperative use of pain medicine and opioids on 14.082 patients who underwent spine surgery due to spinal stenosis (n=7.932), disc herniation (n=4.573) and spondylolisthesis (n=1.577). 36% of patients were on prescription opioids before surgery, as compared to 17% of patients at 1-year follow-up after surgery. (P<0.001).Overall, patients with preoperative opioid use had an increased relative risk (RR) of 4.70 (P=0.002) of being prolonged opioid users in all patient groups combined. Modifiable risk factors for prolonged postoperative opioid use included pain duration, body mass index and smoking.

CONCLUSION: While opioid use is diminished overall during the seven-year study period, and most patients came of opioids after surgery, we found that preoperative opioid use was the strongest predictor for prolonged postoperative use.

Original language	English
Journal	Spine
ISSN	0362-2436
DOIs	https://doi.org/10.1097/BRS.0000000000005241
Publication status	E-pub ahead of print - 18. Apr 2025

Keywords

disc herniation
lumbar spine surgery
opioid
prolonged opioid use
spinal stenosis
spondylolisthesis

Documents & Links

10.1097/BRS.0000000000005241

SDU Link

Check access to the material in SDU Library's search engine

Cite this

Andresen, A. K., Carreon, L. Y., Bech, R., Bjarkam, C. R., Bruun, C., Caspersen, J., Dons, K., Jørgensen, L. M., Rasmussen, M., Nielsen, M., Nielsen, T. H., Pedersen, C., Rickers, K., Rousing, R., Skov, S. T., & Andersen, M. Ø. (2025). Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study. Spine. Advance online publication. https://doi.org/10.1097/BRS.0000000000005241

@article{9080fccebfc445afa9237f4db62f412b,

title = "Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study",

abstract = "STUDY DESIGN: Retrospective cohort study.OBJECTIVE: The purpose of the current study is to describe long-term opioid use following lumbar spine surgery and, to investigate risk factors associated with prolonged use of opioids in patients undergoing spine surgery to treat chronic pain.SUMMARY OF BACKGROUND DATA: During the last decade, the use of opioids in management of non-malignant pain has been a topic of interest to surgeons and politicians worldwide with reference to the {"}opioid epidemic{"} in the United States. Although WHO guidelines advice against use of opioids to treat chronic low back pain in patients with degenerative spine orders, such therapy is still administered to vast numbers of patients all over the world.MATERIALS AND METHODS: This is an observational study of 14,082 patients based on a nationwide database of spine surgeries (DaneSpine) during the period 2016-2022. We included patients who underwent lumbar spine surgery to treat spinal stenosis, spondylolisthesis and disc herniation. Statistical analysis included descriptive statistics and Relative Risk analysis for factors associated with one-year postoperative opioid use.RESULTS: We had available data on pre- and postoperative use of pain medicine and opioids on 14.082 patients who underwent spine surgery due to spinal stenosis (n=7.932), disc herniation (n=4.573) and spondylolisthesis (n=1.577). 36% of patients were on prescription opioids before surgery, as compared to 17% of patients at 1-year follow-up after surgery. (P<0.001).Overall, patients with preoperative opioid use had an increased relative risk (RR) of 4.70 (P=0.002) of being prolonged opioid users in all patient groups combined. Modifiable risk factors for prolonged postoperative opioid use included pain duration, body mass index and smoking.CONCLUSION: While opioid use is diminished overall during the seven-year study period, and most patients came of opioids after surgery, we found that preoperative opioid use was the strongest predictor for prolonged postoperative use.",

keywords = "disc herniation, lumbar spine surgery, opioid, prolonged opioid use, spinal stenosis, spondylolisthesis",

author = "Andresen, {Andreas K.} and Carreon, {Leah Y.} and Rune Bech and Bjarkam, {Carsten R.} and Carsten Bruun and Jon Caspersen and Kjeld Dons and J{\o}rgensen, {Louise M{\o}ller} and Mikkel Rasmussen and Michael Nielsen and Nielsen, {Troels Hafeldt} and Casper Pedersen and Kresten Rickers and Rikke Rousing and Skov, {Simon Toftgaard} and Andersen, {Mikkel {\O}sterheden}",

year = "2025",

month = apr,

day = "18",

doi = "10.1097/BRS.0000000000005241",

language = "English",

journal = "Spine",

issn = "0362-2436",

publisher = "Wolters Kluwer Health",

}

Andresen, AK , Carreon, LY, Bech, R, Bjarkam, CR, Bruun, C, Caspersen, J, Dons, K, Jørgensen, LM, Rasmussen, M, Nielsen, M, Nielsen, TH, Pedersen, C, Rickers, K, Rousing, R, Skov, ST & Andersen, MØ 2025, 'Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study', Spine. https://doi.org/10.1097/BRS.0000000000005241

TY - JOUR

T1 - Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study

AU - Andresen, Andreas K.

AU - Carreon, Leah Y.

AU - Bech, Rune

AU - Bjarkam, Carsten R.

AU - Bruun, Carsten

AU - Caspersen, Jon

AU - Dons, Kjeld

AU - Jørgensen, Louise Møller

AU - Rasmussen, Mikkel

AU - Nielsen, Michael

AU - Nielsen, Troels Hafeldt

AU - Pedersen, Casper

AU - Rickers, Kresten

AU - Rousing, Rikke

AU - Skov, Simon Toftgaard

AU - Andersen, Mikkel Østerheden

PY - 2025/4/18

Y1 - 2025/4/18

N2 - STUDY DESIGN: Retrospective cohort study.OBJECTIVE: The purpose of the current study is to describe long-term opioid use following lumbar spine surgery and, to investigate risk factors associated with prolonged use of opioids in patients undergoing spine surgery to treat chronic pain.SUMMARY OF BACKGROUND DATA: During the last decade, the use of opioids in management of non-malignant pain has been a topic of interest to surgeons and politicians worldwide with reference to the "opioid epidemic" in the United States. Although WHO guidelines advice against use of opioids to treat chronic low back pain in patients with degenerative spine orders, such therapy is still administered to vast numbers of patients all over the world.MATERIALS AND METHODS: This is an observational study of 14,082 patients based on a nationwide database of spine surgeries (DaneSpine) during the period 2016-2022. We included patients who underwent lumbar spine surgery to treat spinal stenosis, spondylolisthesis and disc herniation. Statistical analysis included descriptive statistics and Relative Risk analysis for factors associated with one-year postoperative opioid use.RESULTS: We had available data on pre- and postoperative use of pain medicine and opioids on 14.082 patients who underwent spine surgery due to spinal stenosis (n=7.932), disc herniation (n=4.573) and spondylolisthesis (n=1.577). 36% of patients were on prescription opioids before surgery, as compared to 17% of patients at 1-year follow-up after surgery. (P<0.001).Overall, patients with preoperative opioid use had an increased relative risk (RR) of 4.70 (P=0.002) of being prolonged opioid users in all patient groups combined. Modifiable risk factors for prolonged postoperative opioid use included pain duration, body mass index and smoking.CONCLUSION: While opioid use is diminished overall during the seven-year study period, and most patients came of opioids after surgery, we found that preoperative opioid use was the strongest predictor for prolonged postoperative use.

AB - STUDY DESIGN: Retrospective cohort study.OBJECTIVE: The purpose of the current study is to describe long-term opioid use following lumbar spine surgery and, to investigate risk factors associated with prolonged use of opioids in patients undergoing spine surgery to treat chronic pain.SUMMARY OF BACKGROUND DATA: During the last decade, the use of opioids in management of non-malignant pain has been a topic of interest to surgeons and politicians worldwide with reference to the "opioid epidemic" in the United States. Although WHO guidelines advice against use of opioids to treat chronic low back pain in patients with degenerative spine orders, such therapy is still administered to vast numbers of patients all over the world.MATERIALS AND METHODS: This is an observational study of 14,082 patients based on a nationwide database of spine surgeries (DaneSpine) during the period 2016-2022. We included patients who underwent lumbar spine surgery to treat spinal stenosis, spondylolisthesis and disc herniation. Statistical analysis included descriptive statistics and Relative Risk analysis for factors associated with one-year postoperative opioid use.RESULTS: We had available data on pre- and postoperative use of pain medicine and opioids on 14.082 patients who underwent spine surgery due to spinal stenosis (n=7.932), disc herniation (n=4.573) and spondylolisthesis (n=1.577). 36% of patients were on prescription opioids before surgery, as compared to 17% of patients at 1-year follow-up after surgery. (P<0.001).Overall, patients with preoperative opioid use had an increased relative risk (RR) of 4.70 (P=0.002) of being prolonged opioid users in all patient groups combined. Modifiable risk factors for prolonged postoperative opioid use included pain duration, body mass index and smoking.CONCLUSION: While opioid use is diminished overall during the seven-year study period, and most patients came of opioids after surgery, we found that preoperative opioid use was the strongest predictor for prolonged postoperative use.

KW - disc herniation

KW - lumbar spine surgery

KW - opioid

KW - prolonged opioid use

KW - spinal stenosis

KW - spondylolisthesis

U2 - 10.1097/BRS.0000000000005241

DO - 10.1097/BRS.0000000000005241

M3 - Journal article

C2 - 40247626

AN - SCOPUS:105004888299

SN - 0362-2436

JO - Spine

JF - Spine

ER -

Perioperative Opioid Consumption in Patients who Undergo Surgery due to Spine Related Pain. A Danish Nationwide Cohort Study

Abstract

Keywords

Documents & Links

SDU Link

Fingerprint

Cite this