Evidence-Based Orthopaedic Post-Operative Opioid Prescribing Recommendations Following Spine Surgery

Abstract

The initiation of illegal opioid use often stems from legal prescriptions, emphasizing the pivotal role of healthcare practitioners, particularly physicians, in addressing this crisis. Opioid medications are frequently prescribed after surgeries, with orthopedic and neurosurgery procedures demonstrating higher rates of opioid utilization. Notably, spine surgeries exhibit the highest rates of long-term opioid prescription usage. Preoperative opioid use is prevalent among patients undergoing spine surgery and is associated with an increased risk of opioid dependence one year after the procedure. It is crucial to consider specific surgical characteristics when deciding on postoperative opioid use, as fewer intensive procedures tend to have a higher likelihood of discontinuing opioid use compared to lumbar interbody arthrodesis. Orthopedic spine surgeons must address unique pain management challenges, considering preoperative opioid use and focusing on multimodal pain relief methods to improve patients’ quality of life.