Minimally invasive spine surgery was associated with reduced opioid consumption, with endoscopic procedures having the lowest average use, according to a study published March 18 for the Global Spine Journal.
Five things to know:
1. Researchers evaluated a prospective cohort of 217 opioid-naive patients undergoing outpatient spine surgery from August 2023 to December 2024. They were stratified by approach (open, tubular, endoscopic) and single-vs multilevel procedures.
2. Patient-reported pill counts and follow-up interviews at three months postoperatively. Among lumbar surgeries, endoscopic procedures had the lowest average opioid use with patients using an average 48.6 morphine milligram equivalents. Patients having open procedures used an average 164.7 MME.
3. Overall, 17.5% of patients didn’t use any postoperative opioids at all. The highest rate of no opioid use at all was in the single-level endoscopic spine group.
4. Single-level spine patients used “significantly fewer” opioids than multi-level spine patients.
5. The study concluded, “Minimally invasive spine surgery techniques, particularly endoscopic and tubular approaches, were associated with reduced postoperative opioid use and fewer refill requests compared to open procedures within this heterogeneous cohort of lumbar and cervical procedures. Multilevel surgeries were associated with higher opioid consumption. These findings support the development of tailored opioid prescribing protocols for opioid-naive patients, potentially reducing overprescription and improving pain management. Patient education on non-opioid analgesia and standardized prescribing guidelines may further reduce opioid reliance after spine surgery.”
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