{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:54:48Z","timestamp":1785372888211,"version":"3.55.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Opioids are commonly prescribed after surgery for painful spinal conditions, yet little is known about postoperative opioid use. The relationship between chronic opioid use and patient-reported outcomes and satisfaction with surgery is also unclear. The purpose of this study was to evaluate factors associated with opioid use 1 year after elective cervical spine surgery for degenerative conditions causing radiculopathy and myelopathy. The authors hypothesized that patients with preoperative opioid use would be more likely to report postoperative opioid use at 1 year, and that postoperative opioid use would be associated with patient-reported outcomes and dissatisfaction with surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors performed a retrospective study of a prospective cohort of adult patients who underwent elective cervical spine surgery for degenerative changes causing radiculopathy or myelopathy. Patients were prospectively and consecutively enrolled from a single academic center after the decision for surgery had been made. Postoperative in-hospital pain management was conducted using a standardized protocol. The primary outcome was any opioid use 1 year after surgery. Secondary outcomes were the Neck Disability Index (NDI); 36-Item Short-Form Health Survey (SF-36) physical function (PF), bodily pain (BP), and mental component summary (MCS) scores; the modified Japanese Orthopaedic Association (mJOA) score among myelopathy patients; and patient expectations surveys. Patients with and without preoperative opioid use were compared using the chi-square and Student t-tests, and multiple logistic regression was used to study the associations between patient and surgical characteristics and postoperative opioid use 1 year after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Two hundred eleven patients were prospectively and consecutively enrolled, of whom 39 were lost to follow-up for the primary outcome; 43.6% reported preoperative opioid use. Preoperative NDI and SF-36 PF and BP scores were significantly worse in the preoperative opioid cohort. More than 94% of both cohorts rated expectations of pain relief as extremely or somewhat important. At 1 year after surgery, 50.7% of the preoperative-opioid-use cohort reported ongoing opioid use, and 17.5% of patients in the no-preoperative-opioid-use cohort reported ongoing opioid use. Despite this, both cohorts reported similar improvements in NDI as well as SF-36 PF, BP, and MCS scores. More than 70% of both cohorts also reported being extremely or somewhat satisfied with pain relief after surgery. Predictors of 1-year opioid use included preoperative opioid use, duration of symptoms for more than 9 months before surgery, tobacco use, and higher comorbidity index.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>One year after elective cervical spine surgery, patients with preoperative opioid use were significantly more likely to report ongoing opioid use. However, patients in both groups reported similar improvements in patient-reported outcomes and satisfaction with pain relief. Interventions targeted at decreasing opioid use may need to focus on patient factors such as preoperative opioid use or duration of symptoms before surgery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.7.spine19563","type":"journal-article","created":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T23:00:52Z","timestamp":1570834852000},"page":"1-8","source":"Crossref","is-referenced-by-count":29,"title":["Factors associated with chronic opioid use after cervical spine surgery for degenerative conditions"],"prefix":"10.3171","volume":"32","author":[{"given":"Marjorie C.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Lozen","sequence":"additional","affiliation":[{"name":"Neurosurgical Specialists of South Florida, Aventura, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purushottam W.","family":"Laud","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Institute for Health and Equity, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann B.","family":"Nattinger","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin E.","family":"Krebs","sequence":"additional","affiliation":[{"name":"Minneapolis VA Health Care System, and University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.spinee.2010.02.007","article-title":"Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion","volume":"10","author":"Carreon LY","year":"2010","unstructured":"Carreon LY, Glassman SD, Campbell MJ, Anderson PA: Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion. Spine J 10:469\u2013474, 20102035995810.1016\/j.spinee.2010.02.007"},{"key":"b2","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1097\/00006123-199904000-00041","article-title":"Cervical spondylotic myelopathy: patterns of neurological deficit and recovery after anterior cervical decompression","volume":"44","author":"Chiles BW III","year":"1999","unstructured":"Chiles BW III, Leonard MA, Choudhri HF, Cooper PR: Cervical spondylotic myelopathy: patterns of neurological deficit and recovery after anterior cervical decompression. Neurosurgery 44:762\u2013770, 19991020130110.1097\/00006123-199904000-00041"},{"key":"b3","series-title":"Am J Prev Med","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1016\/j.amepre.2010.01.022","article-title":"Hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers","volume":"38","author":"Coben JH","year":"2010","unstructured":"Coben JH, Davis SM, Furbee PM, Sikora RD, Tillotson RD, Bossarte RM: Hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers. Am J Prev Med 38:517\u2013524, 201010.1016\/j.amepre.2010.01.02220409500"},{"key":"b4","series-title":"Clin Spine Surg","doi-asserted-by":"publisher","first-page":"E19","DOI":"10.1097\/BSD.0000000000000545","article-title":"Preoperative opioid use: a risk factor for poor return to work status after single-level cervical fusion for radiculopathy in a workers\u2019 compensation setting","volume":"31","author":"Faour M","year":"2018","unstructured":"Faour M, Anderson JT, Haas AR, Percy R, Woods ST, Ahn UM, : Preoperative opioid use: a risk factor for poor return to work status after single-level cervical fusion for radiculopathy in a workers\u2019 compensation setting. Clin Spine Surg 31:E19\u2013E24, 201810.1097\/BSD.0000000000000545"},{"key":"b5","series-title":"JAMA Netw Open","doi-asserted-by":"publisher","first-page":"e180217","DOI":"10.1001\/jamanetworkopen.2018.0217","article-title":"The burden of opioid-related mortality in the United States","volume":"1","author":"Gomes T","year":"2018","unstructured":"Gomes T, Tadrous M, Mamdani MM, Paterson JM, Juurlink DN: The burden of opioid-related mortality in the United States. JAMA Netw Open 1:e180217, 201810.1001\/jamanetworkopen.2018.021730646062"},{"key":"b6","series-title":"Clin J Pain","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1097\/AJP.0b013e3181ff04ca","article-title":"Economic costs of nonmedical use of prescription opioids","volume":"27","author":"Hansen RN","year":"2011","unstructured":"Hansen RN, Oster G, Edelsberg J, Woody GE, Sullivan SD: Economic costs of nonmedical use of prescription opioids. Clin J Pain 27:194\u2013202, 20112117860110.1097\/AJP.0b013e3181ff04ca"},{"key":"b7","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1213\/ane.0b013e31818c7b99","article-title":"The effects of smoking status on opioid tapering among patients with chronic pain","volume":"108","author":"Hooten WM","year":"2009","unstructured":"Hooten WM, Townsend CO, Bruce BK, Warner DO: The effects of smoking status on opioid tapering among patients with chronic pain. Anesth Analg 108:308\u2013315, 20091909586710.1213\/ane.0b013e31818c7b99"},{"key":"b8","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1016\/j.spinee.2018.03.015","article-title":"Chronic preoperative opioid use is a risk factor for increased complications, resource use, and costs after cervical fusion","volume":"18","author":"Jain N","unstructured":"Jain N, Brock JL, Phillips FM, Weaver T, Khan SN: Chronic preoperative opioid use is a risk factor for increased complications, resource use, and costs after cervical fusion. Spine J 18:1989\u20131998, 20182970955310.1016\/j.spinee.2018.03.015"},{"key":"b9","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2651","DOI":"10.1097\/BRS.0b013e31818dad07","article-title":"Development of an index to characterize the \"invasiveness\" of spine surgery: validation by comparison to blood loss and operative time","volume":"33","author":"Mirza SK","year":"2008","unstructured":"Mirza SK, Deyo RA, Heagerty PJ, Konodi MA, Lee LA, Turner JA, : Development of an index to characterize the \"invasiveness\" of spine surgery: validation by comparison to blood loss and operative time. Spine (Phila Pa 1976) 33:2651\u20132662, 200810.1097\/BRS.0b013e31818dad07"},{"key":"b10","series-title":"Arthritis Care Res (Hoboken)","article-title":"Factors associated with opioid use in pre-surgical knee, hip and spine osteoarthritis patients","author":"Power JD","unstructured":"Power JD, Perruccio AV, Gandhi R, Veillette C, Davey JR, Lewis SJ, : Factors associated with opioid use in pre-surgical knee, hip and spine osteoarthritis patients. Arthritis Care Res (Hoboken) [epub ahead of print], 2019"},{"key":"b11","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1974","DOI":"10.1016\/j.spinee.2018.03.018","article-title":"Opioid use following cervical spine surgery: trends and factors associated with long-term use","volume":"18","author":"Pugely AJ","year":"2018","unstructured":"Pugely AJ, Bedard NA, Kalakoti P, Hendrickson NR, Shillingford JN, Laratta JL, : Opioid use following cervical spine surgery: trends and factors associated with long-term use. Spine J 18:1974\u20131981, 20182965324410.1016\/j.spinee.2018.03.018"},{"key":"b12","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E849","DOI":"10.1097\/BRS.0b013e3182959e4e","article-title":"Does opioid pain medication use affect the outcome of patients with lumbar disc herniation?","volume":"38","author":"Radcliff K","year":"2013","unstructured":"Radcliff K, Freedman M, Hilibrand A, Isaac R, Lurie JD, Zhao W, : Does opioid pain medication use affect the outcome of patients with lumbar disc herniation? Spine (Phila Pa 1976) 38:E849\u2013E860, 201310.1097\/BRS.0b013e3182959e4e"},{"key":"b13","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.2106\/JBJS.16.01075","article-title":"Risk factors for prolonged opioid use following spine surgery, and the association with surgical intensity, among opioid-naive patients","volume":"99","author":"Schoenfeld AJ","year":"2017","unstructured":"Schoenfeld AJ, Nwosu K, Jiang W, Yau AL, Chaudhary MA, Scully RE, : Risk factors for prolonged opioid use following spine surgery, and the association with surgical intensity, among opioid-naive patients. J Bone Joint Surg Am 99:1247\u20131252, 201710.2106\/JBJS.16.0107528763410"},{"key":"b14","series-title":"J Pain","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.jpain.2006.03.004","article-title":"Factors associated with early opioid prescription among workers with low back injuries","volume":"7","author":"Stover BD","year":"2006","unstructured":"Stover BD, Turner JA, Franklin G, Gluck JV, Fulton-Kehoe D, Sheppard L, : Factors associated with early opioid prescription among workers with low back injuries. J Pain 7:718\u2013725, 200610.1016\/j.jpain.2006.03.00417018332"},{"key":"b15","article-title":"US Office of National Drug Control Policy: The President\u2019s Commission on Combating Drug Addiction and the Opioid Crisis","year":"2017","unstructured":"US Office of National Drug Control Policy: The President\u2019s Commission on Combating Drug Addiction and the Opioid Crisis. Washington, DC: The White House, 2017 (https:\/\/www.whitehouse.gov\/sites\/whitehouse.gov\/files\/images\/Final_Report_Draft_11-1-2017.pdf) [Accessed August 5, 2019]"},{"key":"b16","series-title":"J Manipulative Physiol Ther","first-page":"409","article-title":"The Neck Disability Index: a study of reliability and validity","volume":"14","author":"Vernon H","year":"1991","unstructured":"Vernon H, Mior S: The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther 14:409\u2013415, 19911834753"},{"key":"b17","series-title":"Med Care","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware JE Jr","year":"1992","unstructured":"Ware JE Jr, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473\u2013483, 1992159391410.1097\/00005650-199206000-00002"},{"key":"b18","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1097\/BRS.0b013e318145a731","article-title":"Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use","volume":"32","author":"Webster BS","year":"2007","unstructured":"Webster BS, Verma SK, Gatchel RJ: Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use. Spine (Phila Pa 1976) 32:2127\u20132132, 200710.1097\/BRS.0b013e318145a731"},{"key":"b19","series-title":"Acta Orthop","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1080\/17453670610046064","article-title":"SF-36 scores in degenerative lumbar spine disorders: analysis of prospective data from 451 patients","volume":"77","author":"Zanoli G","year":"2006","unstructured":"Zanoli G, J\u00f6nsson B, Str\u00f6mqvist B: SF-36 scores in degenerative lumbar spine disorders: analysis of prospective data from 451 patients. Acta Orthop 77:298\u2013306, 20061675229410.1080\/17453670610046064"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/1\/article-p1.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/32\/1\/article-p1.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T22:48:57Z","timestamp":1681598937000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/32\/1\/article-p1.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":19,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2019.7.spine19563","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}