The effect of preoperative neuroleptics and opioids on post-operative pain and disability following spinal surgery for lumbar radiculopathy
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Date
2023-08
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University of New Brunswick
Abstract
Despite common treatments of lumbar radiculopathy, a subset of patients do not meet satisfactory clinical outcomes. Our study aims to estimate the effect of preoperative opioids and neuroleptics on postoperative pain and disability of patients who underwent spine surgery, with or without fusion, for lumbar radiculopathy. Patients reported preoperative medication use as none, intermittent, or daily. Study outcomes were leg, back pain, measured with the numeric rating scale and disability scores measured with the modified Oswestry Disability Index at 3-,12 –and-24 months postoperatively. We constructed propensity score models using inverse-probability weights and regression adjustment to account for confounding: age, sex, education, smoking, depression risk, and baseline pain or disability. Preoperative opioids had a small adverse effect on back pain with a maximum effect of [0.55(0.27-0.83)], leg pain [0.32(0.005-0.64)] – [0.36(0.02-0.71)], and disability [2.17(0.45-3.90)] – [3.51(1.46-5.56)] following spine surgery for lumbar radiculopathy. Preoperative neuroleptics did not affect outcomes.
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MEDICINE