Factors Associated with Chronic Opioid Use After Adult Spinal Deformity Surgery

In a Johns Hopkins Medicine study of patients who underwent adult spinal deformity (ASD) surgery, preoperative opioid use and pain duration of 4 or more years were independently associated with higher odds of chronic post-surgery opioid use.

The findings were published online ahead of print by the journal Spine Deformity.

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For the study, the researchers analyzed data from 119 patients who:

  • Had undergone ASD surgery between January 2008 February 2018 at Johns Hopkins Hospital
  • Were age 18 years or older
  • Had the necessary clinical data available (patient-reported preoperative health-related quality of life [HRQoL] and 1- and 2-year postoperative follow-up)

The researchers found that:

  • Patients who had taken opioids preoperatively were 6 times more likely to report chronic opioid use after ASD surgery
  • Patients who had experienced 4 or more years of pain before surgery were 3 times more likely to report postoperative chronic opioid use

Other factors such as age, sex, and history of smoking were not associated with higher odds of chronic post-surgery opioid use.

These results may be useful in preoperative conversations between surgeons and patients about the risk of postoperative opioid addiction.

“Physicians can explain that while most patients do not become addicted to opioids, preoperative opioid use and duration of preoperative pain may increase that risk,” said study author Brian J. Neuman, MD, an Associate Professor of Orthopaedic Surgery at Johns Hopkins University School of Medicine.

“For patients with multiple risk factors and those concerned about addiction, physicians can offer alternative pain management methods, such as non-narcotic medications, and provide early referrals to pain management specialists. Physicians can also assess if there are any behavioral factors that could be better evaluated by a psychologist who specializes in pain management.”


Mo KC, Sachdev R, Zhang B, et al. Preoperative duration of pain is associated with chronic opioid use after adult spinal deformity surgery. Spine Deform. 2022 Jun 24. doi: 10.1007/s43390-022-00531-7. Online ahead of print.

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