Work

From Incision to Prescription: Unraveling Pain and Opioid Use in Adult Spinal Deformity Surgery

Year: 2025

Type: article

Abstract: BACKGROUND: Adult spinal deformity (ASD) surgery often involves extensive spinal realignment to restore spinopelvic parameters and functional alignment. Unfortunately, patients frequently experience significant postoperative pain, often leading to prolonged opioid use. This study investigates patient- and surgery-related factors associated with opioid use and pain following ASD surgery. METHODS: We conducted a retrospective review of ASD cases performed at our institution between 2016 and 2023. All patients underwent multilevel spinal fusion for correction of scoliosis and/or kyphosis. RESULTS: = 0.009). CONCLUSION: This study highlights several key risk factors for prolonged opioid dependence and elevated postoperative pain in ASD surgery, including preoperative narcotic use, postoperative PI < 55°, revision surgery for mechanical complications, and specific osteotomy techniques. The protective effect of IDO in reducing pain and opioid duration is most likely due to more harmonious correction of lumbar lordosis and an improvement in lumbar lordosis-PI mismatch. CLINICAL RELEVANCE: These findings underscore the importance of preoperative optimization, opioid-sparing pain management strategies, and enhanced recovery pathways to mitigate long-term opioid reliance and improve patient outcomes.

Source: The International Journal of Spine Surgery

DOI: 10.14444/8791