{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:02:40Z","timestamp":1789394560151,"version":"build-2803163510"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate 10-year outcomes of medical cannabis therapy on opioid use, pain intensity, functional disability, concomitant medication use, and adverse events in cannabis-na\u00efve chronic low back pain (CLBP) patients, with particular attention to clinically meaningful outcomes defined by established minimal clinically important difference (MCID) thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-center longitudinal observational study of 1,000 consecutive cannabis-na\u00efve CLBP patients from a registry database (2015\u20132024), reported following STROBE guidelines. Primary outcome: morphine milligram equivalents (MMEQ). Secondary outcomes: Numeric Rating Scale (NRS) for pain intensity, Oswestry Disability Index (ODI) for functional disability, cannabis dosing patterns, adverse events, and concomitant medication use. Pre-specified MCID thresholds: \u226550% MMEQ reduction, \u2265\u200930% NRS reduction, \u2265\u200910-point ODI improvement. Statistical analyses included paired t-tests for completers and linear mixed-effects models for sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1,000 enrolled patients, 638 (63.8%) completed 10-year follow-up. Among completers, MMEQ decreased from 62.8\u2009\u00b1\u200935.7 to 6.4\u2009\u00b1\u20097.1\u00a0mg\/day (\u2212\u200989.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); NRS from 8.71\u2009\u00b1\u20091.23 to 1.37\u2009\u00b1\u20091.71 (\u2212\u200984.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); ODI from 52.9\u2009\u00b1\u200911.9% to 36.8\u2009\u00b1\u200914.9% (16.1-point reduction, \u2212\u200930.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). MCID responders: 91.2% for MMEQ, 96.6% for NRS, 62.1% for ODI. Substantial polypharmacy reductions occurred: tramadol\/tapentadol\u2009\u2212\u200984.0% points (pp), benzodiazepines\u2009\u2212\u200973.5 pp, SSRIs\u2009\u2212\u200971.9 pp, gabapentinoids\u2009\u2212\u200930.7 pp. True tolerability adverse events occurred in 11.4% of visits; serious psychiatric events in 0.02%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this uncontrolled observational study, medical cannabis therapy was associated with reductions in opioid use, pain intensity, and functional disability over 10 years, accompanied by polypharmacy reduction and acceptable tolerability. Effect sizes substantially exceeded RCT benchmarks (e.g., \u2212\u20090.6 NRS difference vs. placebo in a recent phase 3 trial), suggesting observational biases contribute to these findings. These hypothesis-generating data warrant validation in randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00586-026-10290-y","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:16:08Z","timestamp":1789384568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ten-year outcomes of medical cannabis for chronic low back pain: opioid reduction, pain relief, and functional improvement in 1,000 patients"],"prefix":"10.1007","author":[{"given":"Muhammad","family":"Khatib","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dror","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eitan","family":"Lavon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Qawasmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem","family":"Abu Rashed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Murad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Yassin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"10290_CR1","doi-asserted-by":"publisher","first-page":"e316","DOI":"10.1016\/S2665-9913(23)00098-X","volume":"5","author":"GBD 2021 Low Back Pain Collaborators","year":"2023","unstructured":"GBD 2021 Low Back Pain Collaborators (2023) Global, regional, and national burden of low back pain, 1990\u20132020, its attributable risk factors, and projections to 2050. Lancet Rheumatol 5:e316\u2013e329","journal-title":"Lancet Rheumatol"},{"key":"10290_CR2","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1136\/annrheumdis-2013-204428","volume":"73","author":"D Hoy","year":"2014","unstructured":"Hoy D, March L, Brooks P et al (2014) The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 73:968\u2013974","journal-title":"Ann Rheum Dis"},{"key":"10290_CR3","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","volume":"67","author":"J Dahlhamer","year":"2018","unstructured":"Dahlhamer J, Lucas J, Zelaya C et al (2018) Prevalence of chronic pain and high-impact chronic pain among adults\u2014United States, 2016. MMWR Morb Mortal Wkly Rep 67:1001\u20131006","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10290_CR4","doi-asserted-by":"publisher","first-page":"2356","DOI":"10.1016\/S0140-6736(18)30480-X","volume":"391","author":"J Hartvigsen","year":"2018","unstructured":"Hartvigsen J, Hancock MJ, Kongsted A et al (2018) What low back pain is and why we need to pay attention. Lancet 391:2356\u20132367","journal-title":"Lancet"},{"key":"10290_CR5","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1136\/bmj.327.7410.323","volume":"327","author":"LH Pengel","year":"2003","unstructured":"Pengel LH, Herbert RD, Maher CG, Refshauge KM (2003) Acute low back pain: systematic review of its prognosis. BMJ 327:323","journal-title":"BMJ"},{"key":"10290_CR6","doi-asserted-by":"publisher","first-page":"305","DOI":"10.2519\/jospt.2017.7415","volume":"47","author":"T da Silva","year":"2017","unstructured":"da Silva T, Mills K, Brown BT et al (2017) Risk of recurrence of low back pain: a systematic review. J Orthop Sports Phys Ther 47:305\u2013313","journal-title":"J Orthop Sports Phys Ther"},{"key":"10290_CR7","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1097\/00007632-198709000-00002","volume":"12","author":"G Waddell","year":"1987","unstructured":"Waddell G (1987) A new clinical model for the treatment of low-back pain. Spine 12:632\u2013644","journal-title":"Spine"},{"key":"10290_CR8","doi-asserted-by":"publisher","first-page":"E109","DOI":"10.1097\/00007632-200203010-00017","volume":"27","author":"T Pincus","year":"2002","unstructured":"Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity\/disability in prospective cohorts of low back pain. Spine 27:E109\u2013E120","journal-title":"Spine"},{"key":"10290_CR9","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/S0304-3959(99)00242-0","volume":"85","author":"JWS Vlaeyen","year":"2000","unstructured":"Vlaeyen JWS, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317\u2013332","journal-title":"Pain"},{"key":"10290_CR10","doi-asserted-by":"publisher","first-page":"514","DOI":"10.7326\/M16-2367","volume":"166","author":"A Qaseem","year":"2017","unstructured":"Qaseem A, Wilt TJ, McLean RM et al (2017) Noninvasive treatments for acute, subacute, and chronic low back pain. Ann Intern Med 166:514\u2013530","journal-title":"Ann Intern Med"},{"key":"10290_CR11","volume-title":"WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings","author":"World Health Organization","year":"2023","unstructured":"World Health Organization (2023) WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings. WHO, Geneva"},{"key":"10290_CR12","first-page":"CD012087","volume":"2","author":"WTM Enthoven","year":"2016","unstructured":"Enthoven WTM, Roelofs PDDM, Deyo RA et al (2016) Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database Syst Rev 2:CD012087","journal-title":"Cochrane Database Syst Rev"},{"key":"10290_CR13","doi-asserted-by":"publisher","first-page":"E786","DOI":"10.1503\/cmaj.171333","volume":"190","author":"O Enke","year":"2018","unstructured":"Enke O, New HA, New CH et al (2018) Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ 190:E786\u2013E793","journal-title":"CMAJ"},{"key":"10290_CR14","first-page":"1","volume":"491","author":"CDC","year":"2023","unstructured":"CDC (2023) Drug Overdose Deaths, 2002\u20132022. NCHS Data Brief 491:1\u20138","journal-title":"NCHS Data Brief"},{"key":"10290_CR15","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1056\/NEJMra1507771","volume":"374","author":"ND Volkow","year":"2016","unstructured":"Volkow ND, McLellan AT (2016) Opioid abuse in chronic pain\u2014misconceptions and mitigation strategies. N Engl J Med 374:1253\u20131263","journal-title":"N Engl J Med"},{"key":"10290_CR16","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1001\/jama.2016.1464","volume":"315","author":"D Dowell","year":"2016","unstructured":"Dowell D, Haegerich TM, Chou R (2016) CDC guideline for prescribing opioids for chronic pain\u2014United States, 2016. JAMA 315:1624\u20131645","journal-title":"JAMA"},{"key":"10290_CR17","doi-asserted-by":"publisher","first-page":"276","DOI":"10.7326\/M14-2559","volume":"162","author":"R Chou","year":"2015","unstructured":"Chou R, Turner JA, Devine EB et al (2015) The effectiveness and risks of long-term opioid therapy for chronic pain. Ann Intern Med 162:276\u2013286","journal-title":"Ann Intern Med"},{"key":"10290_CR18","first-page":"607","volume":"6","author":"HC Lu","year":"2021","unstructured":"Lu HC, Mackie K (2021) Review of the endocannabinoid system. Biol Psychiatry Cogn Neurosci Neuroimaging 6:607\u2013615","journal-title":"Biol Psychiatry Cogn Neurosci Neuroimaging"},{"key":"10290_CR19","doi-asserted-by":"publisher","first-page":"403","DOI":"10.2174\/187152709789824660","volume":"8","author":"J Guindon","year":"2009","unstructured":"Guindon J, Hohmann AG (2009) The endocannabinoid system and pain. CNS Neurol Disord Drug Targets 8:403\u2013421","journal-title":"CNS Neurol Disord Drug Targets"},{"key":"10290_CR20","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1124\/pr.54.2.161","volume":"54","author":"AC Howlett","year":"2002","unstructured":"Howlett AC, Barth F, Bonner TI et al (2002) International Union of Pharmacology. XXVII. Classification of cannabinoid receptors. Pharmacol Rev 54:161\u2013202","journal-title":"Pharmacol Rev"},{"key":"10290_CR21","doi-asserted-by":"publisher","first-page":"4449","DOI":"10.1007\/s00018-016-2300-4","volume":"73","author":"C Turcotte","year":"2016","unstructured":"Turcotte C, Blanchet MR, Laviolette M, Bhomley MA (2016) The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci 73:4449\u20134470","journal-title":"Cell Mol Life Sci"},{"key":"10290_CR22","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1089\/can.2016.0037","volume":"2","author":"MS Ibsen","year":"2017","unstructured":"Ibsen MS, Connor M, Glass M (2017) Cannabinoid CB1 and CB2 receptor signaling and bias. Cannabis Cannabinoid Res 2:48\u201360","journal-title":"Cannabis Cannabinoid Res"},{"key":"10290_CR23","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1124\/pr.112.006387","volume":"65","author":"JL Blankman","year":"2013","unstructured":"Blankman JL, Cravatt BF (2013) Chemical probes of endocannabinoid metabolism. Pharmacol Rev 65:849\u2013871","journal-title":"Pharmacol Rev"},{"key":"10290_CR24","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1038\/sj.bjp.0707442","volume":"153","author":"RG Pertwee","year":"2008","unstructured":"Pertwee RG (2008) The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids. Br J Pharmacol 153:199\u2013215","journal-title":"Br J Pharmacol"},{"key":"10290_CR25","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.3389\/fphar.2018.01259","volume":"9","author":"S Vuckovic","year":"2018","unstructured":"Vuckovic S, Srebro D, Vujovic KS et al (2018) Cannabinoids and pain: new insights from old molecules. Front Pharmacol 9:1259","journal-title":"Front Pharmacol"},{"key":"10290_CR26","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1038\/npp.2017.51","volume":"42","author":"S Nielsen","year":"2017","unstructured":"Nielsen S, Sabioni P, Trigo JM et al (2017) Opioid-sparing effect of cannabinoids: a systematic review and meta-analysis. Neuropsychopharmacology 42:1752\u20131765","journal-title":"Neuropsychopharmacology"},{"key":"10290_CR27","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1038\/s41386-022-01322-4","volume":"47","author":"S Nielsen","year":"2022","unstructured":"Nielsen S, Picco L, Murnion B et al (2022) Opioid-sparing effect of cannabinoids for analgesia: an updated systematic review and meta-analysis. Neuropsychopharmacology 47:1315\u20131330","journal-title":"Neuropsychopharmacology"},{"key":"10290_CR28","doi-asserted-by":"publisher","first-page":"e047717","DOI":"10.1136\/bmjopen-2020-047717","volume":"11","author":"A Noori","year":"2021","unstructured":"Noori A, Busse JW, Engles A et al (2021) Opioid-sparing effects of medical cannabis or cannabinoids for chronic pain: a systematic review and meta-analysis. BMJ Open 11:e047717","journal-title":"BMJ Open"},{"key":"10290_CR29","doi-asserted-by":"publisher","first-page":"e068182","DOI":"10.1136\/bmjopen-2022-068182","volume":"14","author":"HM Jeddi","year":"2024","unstructured":"Jeddi HM, Busse JW, Sadeghirad B et al (2024) Cannabis for medical use versus opioids for chronic non-cancer pain: a systematic review and network meta-analysis. BMJ Open 14:e068182","journal-title":"BMJ Open"},{"key":"10290_CR30","doi-asserted-by":"publisher","first-page":"1464005","DOI":"10.3389\/fphar.2024.1464005","volume":"15","author":"SN Melendez","year":"2024","unstructured":"Melendez SN, Ortiz Torres M, Lisano JK et al (2024) Edible cannabis for chronic low back pain: associations with pain, mood, and intoxication. Front Pharmacol 15:1464005","journal-title":"Front Pharmacol"},{"key":"10290_CR31","doi-asserted-by":"publisher","first-page":"109702","DOI":"10.1016\/j.drugalcdep.2022.109702","volume":"241","author":"JP De Aquino","year":"2022","unstructured":"De Aquino JP, Bahji A, G\u00f3mez O, Sofuoglu M (2022) Alleviation of opioid withdrawal by cannabis and delta-9-tetrahydrocannabinol: a systematic review of observational and experimental human studies. Drug Alcohol Depend 241:109702","journal-title":"Drug Alcohol Depend"},{"key":"10290_CR32","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.drugalcdep.2016.05.002","volume":"164","author":"MR Lofwall","year":"2016","unstructured":"Lofwall MR, Babalonis S, Nuzzo PA, Elayi SC, Walsh SL (2016) Opioid withdrawal suppression efficacy of oral dronabinol in opioid dependent humans. Drug Alcohol Depend 164:143\u2013150","journal-title":"Drug Alcohol Depend"},{"key":"10290_CR33","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1097\/AJP.0000000000000022","volume":"30","author":"MA Issa","year":"2014","unstructured":"Issa MA, Narang S, Jamison RN et al (2014) The subjective psychoactive effects of oral dronabinol studied in a randomized, controlled crossover clinical trial for pain. Clin J Pain 30:472\u2013478","journal-title":"Clin J Pain"},{"key":"10290_CR34","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1089\/can.2019.0077","volume":"5","author":"L First","year":"2020","unstructured":"First L, Schutte N, Douglas JA (2020) Cannabis use and low-back pain: a systematic review. Cannabis Cannabinoid Res 5:283\u2013289","journal-title":"Cannabis Cannabinoid Res"},{"key":"10290_CR35","doi-asserted-by":"publisher","first-page":"2910","DOI":"10.1038\/s41591-025-03977-0","volume":"31","author":"M Karst","year":"2025","unstructured":"Karst M, Wippermann S, Ahrens J et al (2025) Full-spectrum extract from Cannabis sativa DKJ127 for chronic low back pain: a phase 3 randomized placebo-controlled trial. Nat Med 31:2910\u20132919","journal-title":"Nat Med"},{"key":"10290_CR36","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M et al (2007) The STROBE statement: guidelines for reporting observational studies. Lancet 370:1453\u20131457","journal-title":"Lancet"},{"key":"10290_CR37","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1002\/pds.3945","volume":"25","author":"S Nielsen","year":"2016","unstructured":"Nielsen S, Degenhardt L, Hoban B, Gisev N (2016) A synthesis of oral morphine equivalents (OME) for opioid utilisation studies. Pharmacoepidemiol Drug Saf 25:733\u2013737","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"10290_CR38","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1016\/j.jpainsymman.2010.08.016","volume":"41","author":"MJ Hjermstad","year":"2011","unstructured":"Hjermstad MJ, Fayers PM, Haugen DF et al (2011) Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity. J Pain Symptom Manage 41:1073\u20131093","journal-title":"J Pain Symptom Manage"},{"key":"10290_CR39","doi-asserted-by":"publisher","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","volume":"25","author":"JC Fairbank","year":"2000","unstructured":"Fairbank JC, Pynsent PB (2000) The Oswestry Disability Index. Spine 25:2940\u20132952","journal-title":"Spine"},{"key":"10290_CR40","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.jpain.2007.09.005","volume":"9","author":"RH Dworkin","year":"2008","unstructured":"Dworkin RH, Turk DC, Wyrwich KW et al (2008) Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9:105\u2013121","journal-title":"J Pain"},{"key":"10290_CR41","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.ejpain.2003.09.004","volume":"8","author":"F Salaffi","year":"2004","unstructured":"Salaffi F, Stancati A, Silvestri CA et al (2004) Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain 8:283\u2013291","journal-title":"Eur J Pain"},{"key":"10290_CR42","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1016\/j.berh.2005.03.003","volume":"19","author":"RW Ostelo","year":"2005","unstructured":"Ostelo RW, de Vet HC (2005) Clinically important outcomes in low back pain. Best Pract Res Clin Rheumatol 19:593\u2013607","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"10290_CR43","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1186\/1471-2474-7-82","volume":"7","author":"HH Lauridsen","year":"2006","unstructured":"Lauridsen HH, Hartvigsen J, Manniche C et al (2006) Responsiveness and minimal clinically important difference for pain and disability instruments in low back pain patients. BMC Musculoskelet Disord 7:82","journal-title":"BMC Musculoskelet Disord"},{"key":"10290_CR44","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1001\/jama.2015.6358","volume":"313","author":"PF Whiting","year":"2015","unstructured":"Whiting PF, Wolff RF, Deshpande S et al (2015) Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 313:2456\u20132473","journal-title":"JAMA"},{"key":"10290_CR45","doi-asserted-by":"publisher","first-page":"E755","DOI":"10.36076\/ppj.20.5.E755","volume":"20","author":"J Aviram","year":"2017","unstructured":"Aviram J, Samuelly-Leichtag G (2017) Efficacy of cannabis-based medicines for pain management: a systematic review and meta-analysis. Pain Physician 20:E755\u2013E796","journal-title":"Pain Physician"},{"key":"10290_CR46","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.36076\/ppj.2017.s92","volume":"20","author":"L Manchikanti","year":"2017","unstructured":"Manchikanti L, Kaye AM, Knezevic NN et al (2017) Responsible, safe, and effective prescription of opioids for chronic non-cancer pain. Pain Physician 20:S3\u2013S92","journal-title":"Pain Physician"},{"key":"10290_CR47","volume-title":"Cannabinoids and Sleep","author":"E Murillo-Rodriguez","year":"2021","unstructured":"Murillo-Rodriguez E, Pandi-Perumal SR, Monti JM (2021) Cannabinoids and Sleep. Springer, Cham"},{"key":"10290_CR48","first-page":"450","volume":"51","author":"A Eklund","year":"2019","unstructured":"Eklund A, Jensen I, Lohela-Karlsson M et al (2019) Long-term outcomes in multidisciplinary treatment of chronic low back pain: costs, comorbidities and healthcare. J Rehabil Med 51:450\u2013460","journal-title":"J Rehabil Med"},{"key":"10290_CR49","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/S2215-0366(19)30048-3","volume":"6","author":"M Di Forti","year":"2019","unstructured":"Di Forti M, Quattrone D, Freeman TP et al (2019) The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe. Lancet Psychiatry 6:427\u2013436","journal-title":"Lancet Psychiatry"},{"key":"10290_CR50","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1007\/s10787-022-01020-z","volume":"30","author":"JD Henson","year":"2022","unstructured":"Henson JD, Vitetta L, Hall S (2022) Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions. Inflammopharmacology 30:1167\u20131178","journal-title":"Inflammopharmacology"},{"key":"10290_CR51","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s42238-021-00073-1","volume":"3","author":"A Bhaskar","year":"2021","unstructured":"Bhaskar A, Bell A, Boivin M et al (2021) Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res 3:22","journal-title":"J Cannabis Res"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-10290-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-026-10290-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-026-10290-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T13:02:21Z","timestamp":1789390941000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-026-10290-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":51,"alternative-id":["10290"],"URL":"https:\/\/doi.org\/10.1007\/s00586-026-10290-y","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"assertion":[{"value":"12 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 February 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}