Pauza Blog

Spinal Fusions Worsen Opioid Epidemic

Because it’s know that spinal fusions cause irreversible damage to good discs adjacent to fusions1,2, it makes sense that spinal fusions are big contributors to the opioid epidemic. The relationship between taking opioids and spine surgery is becoming more important as fusion volumes continue rising and opioid use continues to rise.3 

A respected orthopedic journal, (The Journal of Bone and Joint Surgery), reported that 84% of patients who undergo even simple spine surgery, take opioids for the first time in their lives after having spine surgery.  In that study 9,990 spine surgery patients were followed. An important finding was that none of these spine patients taking opioids after spine surgery never took opioids before their spine surgery.3  

Democratic and Republican politicians recognize societal costs associated with opioid addiction, but seem to focus their attention on people addicted to opioids, and don’t seem to address their attention on underlying causes leading to their addictions.  In the United States, over 19,000 deaths are related to prescription pain medication overdoses every year, and opioid addictions cost $25.6 in workplace lost wages.4  

Therefore, the high failure rate of spinal fusions is not the only reason spinal fusions are falling out of favor, but other issues such as fusions causing the introduction of narcotic pain medications to people who’ve never taken narcotic medications. Spinal fusions are not allowed in North Carolina, due to these reasons recognized by Blue Cross of North Carolina.  

Sources:

(1) Risk of adjacent-segment disease requiring surgery after short lumbar fusion: results of the French Spine Surgery Society Series. Journal of Neurosurgery: Spine. 7:2016.Vol.25.p46-51.  

(2) ISSLS Prize Winner: Long-Term Follow-up Suggests Spinal Fusion Is Associated With Increased Adjacent Segment Disc Degeneration But Without Influence on Clinical Outcome. Results of a Combined Follow-up From 4 Randomized Controlled Trials. Mannion, Anne F. PhD*; Leivseth, Gunnar MD, PhD†; Brox, Jens-Ivar MD, PhD‡; Fritzell, Peter MD, PhD§; Hägg, Olle MD, PhD¶; Fairbank, Jeremy C. T. MD, FRCS‖ Spine: 8:2014.Vol.39.p1373-83. 

(3) Johns Hopkins Bloomberg School of Public Health. The Prescription Opioid Epidemic: An Evidence-Based Approach. 05.02.2016. 

(4) Risk Factors for Prolonged Opioid Use Following Spine Surgery, and the Association with Surgical Intensity, Among Opioid-Naive Patients. Schoenfeld AJ1, Nwosu K, Jiang W, Yau AL, Chaudhary MA, Scully RE, Koehlmoos T, Kang JD, Haider AH. J Bone Joint Surg Am. 2017 Aug 2;99 (15):1247-1252.