The Effect of State-Level Prescription Opioid Legislation on Patient Outcomes After Lumbar Tubular Microdecompression.

Autor:	Beck EC; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA ecbeck@wakehealth.edu., White JC; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA., Gowd AK; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA., Luo TD; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA., Edge C; Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, VA, USA., Knio ZO; Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA., O'Gara TJ; Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.; Department of Neurosurgery Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2022 Jun 16. Date of Electronic Publication: 2022 Jun 16.
DOI:	10.14444/8310
Abstrakt:	Background: In the United States, a statewide legislation titled the Strengthen Opioid Misuse Prevention (STOP) Act was enacted in 2017 to limit prescription opioid use and reduce dependence. The impact of state legislation curbing opioid prescription on outcomes after spine surgery is unknown. Study Design: Case series. Methods: Data from consecutive patients undergoing lumbar tubular microdecompression for symptomatic lumbar spine stenosis from June 2016 to June 2019 were retrospectively analyzed. Cases between June 2016 and December 2017 represent the group before the STOP act (pre-STOP), while cases between January 2018 and June 2019 represent the group after legislation enactment (post-STOP). Preoperative and postoperative patient functional scores including the EuroQol-Five Dimensions Index, Oswestry Disability Index (ODI), and the visual analog scale (VAS) for back and leg pain were compared between both groups. The meaningful clinically important difference (MCID) was calculated for each score and was compared between both groups as well. Results: A total of 147 patients met inclusion criteria, with 86 in the pre-STOP group and 61 in the post-STOP group. Analysis of postoperative scores demonstrated statistically lower VAS leg pain score averages in the post-STOP group ( P < 0.05). Higher trends in achieving MCID among the post-STOP group were observed; however, the differences between both groups were not statistically significant ( P > 0.05 for all). Additionally, there were no statistical differences in rates of unplanned pain-related clinic visits and emergency department (ED) visits, as well as no differences in the number of pain-related calls within 90 days after surgery between both groups. Conclusion: The enactment of state legislation to curb the prescribing of opioids for postoperative pain did not negatively affect the rate of achieving clinically meaningful outcomes among patients undergoing lumbar tubular microdecompression for spinal stenosis. Additionally, decreasing the amount of opioids prescribed for postoperative pain does not increase the number of unplanned clinic or ED visits due to pain within 90 days after surgery. Competing Interests: Declaration of Conflicting Interests: The authors report no conflicts of interest in this work. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2022 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.)
Databáze:	MEDLINE
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