161 Association Between Preoperative Narcotic Use With Surgical Outcomes, Patient Reported Pain Scores and Ambulatory Status After Complex Spinal Fusion (≥5 Levels) for Adult Deformity Correction

Abstract

INTRODUCTION: Despite growing investigation into the opioid crisis in the United States, whether narcotic-use impact surgical outcomes after complex spinal fusion remains relatively understudied. The aim of this study was to evaluate whether there was an association between preoperative narcotic use with surgical outcomes, patient-reported pain scores, and ambulatory status after complex spinal fusions. METHODS: The medical records of 134 adult (=18 yr old) spine deformity patients undergoing elective, primary complex spinal fusion (=5 levels) for deformity correction at a major academic institution from 2005 to 2015 were reviewed. We identified 66 (49.3%) patients who were actively taking narcotics prior to surgery and 68(50.7%) who were not. Patient demographics, comorbidities, intraoperative, and postoperative complication rates were collected for each patient. Inpatient patient-reported pain scores and ambulatory status were also collected. RESULTS: Patient demographics and comorbidities were similar between both cohorts, except for the narcotic user cohort having a greater mean age (57.5 yr vs 50.7 yr, P =.045) and prevalence of depression (39.4% vs 16.2%, P =.003). The median number of fusion levels operated, length of surgery, estimated blood loss, and complication rates were similar between both cohorts. Moreover, the postoperative complication profiles between the cohorts were also similar. The narcotic user cohort had significantly higher pain scores at baseline (6.7 ± 2.4 vs 4.0 ± 3.4, P