Literature DB >> 31493111

Opioids and analgesics use after adult spinal deformity surgery correlates with sagittal alignment and preoperative analgesic pattern.

Anouar Bourghli1, Louis Boissiere2, Daniel Larrieu2, Farah Kaissar2, Derek Cawley2, Takashi Fujishiro2, David Kieser2, Olivier Gille2, Jean-Marc Vital2, Ahmet Alanay3, Ferran Pellisé4, Emre Acaroglu5, Francisco-Javier Perez-Grueso6, Franck Kleinstück7, Ibrahim Obeid2.   

Abstract

PURPOSE: To assess pain, health-related quality of life (HRQOL) scores and sagittal parameters of adult spinal deformity (ASD)-operated patients in the context of their analgesic consumption especially opioids (narcotics) over the first year postoperative period.
METHODS: In total, 372 patients from a multicenter database were stratified into 3 groups at baseline: 241 patients in the minimal group (no analgesic, or NSAIDs/narcotics weekly or less), 64 in the NSAIDs every day group and 67 in the narcotics every day group. HRQOL and back and leg pain scores were evaluated at 6 months and 1 year postoperatively. Also several sagittal alignment parameters were assessed.
RESULTS: Significant improvements in pain and HRQOL scores were observed across all 3 groups by 1 year (P < 0.05) postoperatively. While the minimal group had the best pre- and postoperative HRQOL scores, the NSAID group demonstrated the best improvement in HRQOL. Only the minimal group displayed continued improvement from 6 months to 1 year. 90%, 65% and 40% of minimal, NSAID and narcotic groups of patients, respectively, no longer took any analgesics at 1 year postoperatively. Alternatively, 36% of patients in the narcotics group continued to take narcotics at 1 year. Residual malalignment increased NSAIDs consumption in different groups at 1 year.
CONCLUSION: This study evaluated the analgesics use after ASD surgery in relation to the clinical and radiological outcomes. Despite important postoperative opioids consumption in the narcotics group, clinical outcome yet improved. Malalignment parameters demonstrated a predictive value in regard to NSAIDs' usage. These slides can be retrieved under Electronic Supplementary Material.

Entities:  

Keywords:  Adult spinal deformity; Health-related quality of life scores; NSAID; Opioids; Sagittal alignment

Year:  2019        PMID: 31493111     DOI: 10.1007/s00586-019-06141-8

Source DB:  PubMed          Journal:  Eur Spine J        ISSN: 0940-6719            Impact factor:   3.134


  29 in total

Review 1.  Paracetamol and selective and non-selective non-steroidal anti-inflammatory drugs for the reduction in morphine-related side-effects after major surgery: a systematic review.

Authors:  E Maund; C McDaid; S Rice; K Wright; B Jenkins; N Woolacott
Journal:  Br J Anaesth       Date:  2011-02-01       Impact factor: 9.166

2.  The selection of operative versus nonoperative treatment in patients with adult scoliosis.

Authors:  Steven D Glassman; Frank J Schwab; Keith H Bridwell; Stephen L Ondra; Sigurd Berven; Lawrence G Lenke
Journal:  Spine (Phila Pa 1976)       Date:  2007-01-01       Impact factor: 3.468

3.  Pharmacological management of persistent pain in older persons.

Authors: 
Journal:  J Am Geriatr Soc       Date:  2009-07-02       Impact factor: 5.562

4.  Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient' s readiness for change.

Authors:  N Biller; P Arnstein; M A Caudill; C W Federman; C Guberman
Journal:  Clin J Pain       Date:  2000-12       Impact factor: 3.442

5.  Adult scoliosis: a quantitative radiographic and clinical analysis.

Authors:  Frank J Schwab; Vinson A Smith; Michele Biserni; Lorenzo Gamez; Jean-Pierre C Farcy; Murali Pagala
Journal:  Spine (Phila Pa 1976)       Date:  2002-02-15       Impact factor: 3.468

6.  Improvement of back pain with operative and nonoperative treatment in adults with scoliosis.

Authors:  Justin S Smith; Christopher I Shaffrey; Sigurd Berven; Steven Glassman; Christopher Hamill; William Horton; Stephen Ondra; Frank Schwab; Michael Shainline; Kai-Ming Fu; Keith Bridwell
Journal:  Neurosurgery       Date:  2009-07       Impact factor: 4.654

7.  Pelvic tilt and truncal inclination: two key radiographic parameters in the setting of adults with spinal deformity.

Authors:  Virginie Lafage; Frank Schwab; Ashish Patel; Nicola Hawkinson; Jean-Pierre Farcy
Journal:  Spine (Phila Pa 1976)       Date:  2009-08-01       Impact factor: 3.468

8.  Neurological symptoms and deficits in adults with scoliosis who present to a surgical clinic: incidence and association with the choice of operative versus nonoperative management.

Authors:  Justin S Smith; Kai-Ming Fu; Peter Urban; Christopher I Shaffrey
Journal:  J Neurosurg Spine       Date:  2008-10

9.  Change in classification grade by the SRS-Schwab Adult Spinal Deformity Classification predicts impact on health-related quality of life measures: prospective analysis of operative and nonoperative treatment.

Authors:  Justin S Smith; Eric Klineberg; Frank Schwab; Christopher I Shaffrey; Bertrand Moal; Christopher P Ames; Richard Hostin; Kai-Ming G Fu; Douglas Burton; Behrooz Akbarnia; Munish Gupta; Robert Hart; Shay Bess; Virginie Lafage
Journal:  Spine (Phila Pa 1976)       Date:  2013-09-01       Impact factor: 3.468

10.  Sagittal malalignment has a significant association with postoperative leg pain in adult spinal deformity patients.

Authors:  Mitsuru Takemoto; Louis Boissière; Felipe Novoa; Jean-Marc Vital; Ferran Pellisé; Francisco Javier Sanchez Pérez-Grueso; Frank Kleinstück; Emre R Acaroglu; Ahmet Alanay; Ibrahim Obeid; Ibrahim Obeid
Journal:  Eur Spine J       Date:  2016-05-25       Impact factor: 3.134

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  1 in total

1.  Relative pelvic version displays persistent compensatory measures with normalised sagittal vertical axis after deformity correction.

Authors:  Derek T Cawley; Louis Boissiere; Caglar Yilgor; Daniel Larrieu; Takashi Fujishiro; David Kieser; Ahmet Alanay; Frank Kleinstück; Francisco Sánchez Pérez-Grueso; Ferran Pellisé; Ibrahim Obeid
Journal:  Spine Deform       Date:  2021-04-29
  1 in total

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