{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T17:02:37Z","timestamp":1794502957340,"version":"4.9.1"},"reference-count":13,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Retrospective review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Our purpose was to evaluate factors associated with increased risk of prolonged post-operative opioid pain medication usage following spine surgery, as well as identify the risk of various post-operative complications that may be associated with pre-operative opioid usage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The MarketScan commercial claims and encounters database includes approximately 39 million patients per year. Patients undergoing cervical and lumbar spine surgery between the years 2005-2014 were identified using CPT codes. Pre-operative comorbidities including DSM-V mental health disorders, chronic pain, chronic regional pain syndrome (CRPS), obesity, tobacco use, medications, and diabetes were queried and documented. Patients who utilized opioids from 1-3 months prior to surgery were identified. This timeframe was chosen to exclude patients who had been prescribed pre- and post-operative narcotic medications up to 1 month prior to surgery. We utilized odds ratios (OR), 95% Confidence Intervals (CI), and regression analysis to determine factors that are associated with prolonged post-operative opioid use at 3 time intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>553,509 patients who underwent spine surgery during the 10-year period were identified. 34.9% of patients utilized opioids 1-3 months pre-operatively. 25% patients were still utilizing opioids at 6 weeks, 17.3% at 3 months, 12.7% at 6 months, and 9.0% at 1 year after surgery. Pre-operative opioid exposure was associated with increased likelihood of post-operative use at 6-12 weeks (OR 5.45, 95% CI 5.37-5.53), 3-6 months (OR 6.48, 95% CI 6.37-6.59), 6-12 months (OR 6.97, 95% CI 6.84-7.11), and &gt;12 months (OR 7.12, 95% CI 6.96-7.29). Mental health diagnosis, tobacco usage, diagnosis of chronic pain or CRPS, and non-narcotic neuromodulatory medications yielded increased likelihood of prolonged post-op opioid usage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Pre-operative narcotic use and several patient comorbidities diagnoses are associated with prolonged post-operative opioid usage following spine surgery. Chronic opioid use, diagnosis of chronic pain, or use of non-narcotic neuromodulatory medications have the highest risk of prolonged post-operative opioid consumption. Patients using opiates pre-operatively did have an increased 30 and 90-day readmission risk, in addition to a number of serious post-operative complications. This data provides spine surgeons a number of variables to consider when determining post-operative analgesia strategies, and provides health systems, providers, and payers with information on complications associated with pre-operative opioid utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682211003854","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T08:36:48Z","timestamp":1618475808000},"page":"683-688","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Risk Factors For Prolonged Opioid Use After Spine Surgery"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-0085","authenticated-orcid":false,"given":"Christopher","family":"Kowalski","sequence":"first","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Ridenour","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"McNutt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djibril","family":"Ba","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guodong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Bible","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Aynardi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Garner","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Leslie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Dhawan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hope Drive, Hershey, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"bibr1-21925682211003854","unstructured":"Center for Disease Control and Prevention (CDC). Prescription Opioid Overdose Data. 2017. Accessed August 1, 2017. https:\/\/www.cdc.gov\/drugoverdose\/data\/overdose.html"},{"key":"bibr2-21925682211003854","volume-title":"Drug Overdose Deaths in the United States, 1999-2016","author":"Hedegaard H","year":"2017"},{"key":"bibr3-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-9114.2012.01101.x"},{"issue":"11","key":"bibr4-21925682211003854","first-page":"1374","volume":"18","author":"Shah A","year":"2017","journal-title":"Am Pain Soc"},{"key":"bibr5-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.01.052"},{"key":"bibr6-21925682211003854","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-14-00163"},{"key":"bibr7-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1097\/01.j.pain.0000460357.01998.f1"},{"key":"bibr8-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010664"},{"issue":"0","key":"bibr9-21925682211003854","first-page":"1","volume":"0","author":"Kvarda P","year":"2019","journal-title":"Foot Ankle Int"},{"key":"bibr10-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000622"},{"key":"bibr11-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1177\/1071100716655142"},{"key":"bibr12-21925682211003854","doi-asserted-by":"publisher","DOI":"10.1177\/2333392817734523"},{"key":"bibr13-21925682211003854","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01075"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682211003854","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682211003854","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682211003854","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:17:23Z","timestamp":1777447043000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682211003854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,15]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1177\/21925682211003854"],"URL":"https:\/\/doi.org\/10.1177\/21925682211003854","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,15]]}}}