Predictors of Weeks to Opioid Cessation after Lumbar Fusion: A Prospective Cohort Study

Background: Although the use of prescription opioid analgesics to treat acute, postoperative pain is a well-established practice, the role of opioids in the management of persistent, postoperative pain remains ill-defined. Nevertheless, high rates of long-term opioid use following lumbar fusion have been reported. Aim: The goal of this prospective, longitudinal study was to identify predictors of weeks to opioid cessation in a cohort of patients undergoing elective lumbar fusion. Methods: Prior to surgery, participants self-reported demographic and clinical data and completed a validated measure of pain catastrophizing. Three months following surgery, participants self-reported prescription opioid use. Results: Forty-four percent (n = 22) of participants reported opioid use 12 weeks following lumbar fusion. Bivariate analysis identified a strong correlation between weeks to opioid cessation and preoperative opioid use, r = .46, and a moderate correlation between weeks to opioid cessation and disability, r = .29. The multiple regression model predicting weeks to opioid cessation from age, sex, employment status, educational level, preoperative pain intensity, preoperative opioid use, disability status, and pain catastrophizing was significant, F(8, 38) = 2.254, p = .044, and accounted for 18% of the variance. Among preoperative patient characteristics, only preoperative opioid use significantly predicted weeks to opioid cessation, β = .466; p = .005. Conclusion: Thus, nurses and nurse practitioners may be able to identify patients at risk for long-term opioid use following lumbar fusion by screening patients for preoperative opioid use.