The Relationship between the Pre- and Postoperative Use of Opioid Narcotics and Preoperative Patient-derived Functional Outcomes

Abstract

Background Cervical Myelopathy is dysfunction of spinal cord neurons at the cervical level that results from gradual extrinsic compression by surrounding structures. Surgical decompression is considered appropriate for severe cases. Several studies have shown that patients taking opioid analgesic medications before spinal surgery have less satisfactory outcomes than those who are not. Patient reported outcomes are often used to measure results of spinal procedures. Methods Pre and postoperative opioid prescription data and preoperative patient reported functional scores from a cohort of 401 subjects who underwent surgical decompression for cervical myelopathy were analyzed. A predictive model for postoperative opioid use was developed. Results Patients prescribed opioids at baseline had lower preoperative functional scores than those who were not. The best predictor of postoperative use of opioids was the preoperative use of opioids. Conclusion The effect of preoperative opioid therapy on surgical decision-making and outcomes in cervical myelopathy should be studied further.