Evidence map›Paper›PMID 26140401›Full record

Trial reportJournal of neurosurgery. Spine2015

Preoperative opioid strength may not affect outcomes of anterior cervical procedures: a post hoc analysis of 2 prospective, randomized trials.

Michael P Kelly, Paul A Anderson, Rick C Sasso, K Daniel Riew

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neurosurgery. Spine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Michael P KellyDepartment of Orthopedic Surgery, Washington University School of Medicine, Saint Louis, Missouri;
Paul A AndersonDepartment of Orthopedics & Rehabilitation, University of Wisconsin, Madison, Wisconsin; and.
Rick C SassoDepartment of Orthopedic Surgery, Indiana Spine Group, Indianapolis, Indiana.
K Daniel RiewDepartment of Orthopedic Surgery, Washington University School of Medicine, Saint Louis, Missouri;
Washington University in St. Louis · USIndiana Spine Group · USUniversity of Wisconsin–Madison · US

Funding

Washington University Institute of Clinical and Translational SciencesUL1TR000448 · NCATS · WASHINGTON UNIVERSITY · PI EVANOFF, BRADLEY A · 2012 to 2016
$41.4M
NCATS NIH HHS UL1 TR000448
6 · The paper itself

Abstract

objectThe aim of this study is to evaluate the relationship between preoperative opioid strength and outcomes of anterior cervical decompressive surgery.

methodsA retrospective cohort of 1004 patients enrolled in 1 of 2 investigational device exemption studies comparing cervical total disc arthroplasty (TDA) and anterior cervical discectomy and fusion (ACDF) for single-level cervical disease causing radiculopathy or myelopathy was selected. At a preoperative visit, opioid use data, Neck Disability Index (NDI) scores, 36-Item Short-Form Health Survey (SF-36) scores, and numeric rating scale scores for neck and arm pain were collected. Patients were divided into strong (oxycodone/morphine/meperidine), weak (codeine/propoxyphene/hydrocodone), and opioid-naïve groups. Preoperative and postoperative (24 months) outcomes scores were compared within and between groups using the paired t-test and ANCOVA, respectively.

resultsPatients were categorized as follows: 226 strong, 762 weak, and 16 opioid naïve. The strong and weak groups were similar with respect to age, sex, race, marital status, education level, Worker's Compensation status, litigation status, and alcohol use. At 24-month follow-up, no differences in change in arm or neck pain scores (arm: strong -52.3, weak -50.6, naïve -54.0, p = 0.244; neck: strong -52.7, weak -50.8, naïve -44.6, p = 0.355); NDI scores (strong -36.0, weak -33.3, naïve -32.3, p = 0.181); or SF-36 Physical Component Summary scores (strong: 14.1, weak 13.3, naïve 21.7, p = 0.317) were present. Using a 15-point improvement in NDI to determine success, the authors found no between-groups difference in success rates (strong 80.6%, weak 82.7%, naïve 73.3%, p = 0.134). No difference existed between treatment arms (TDA vs ACDF) for any outcome at any time point.

conclusionsPreoperative opioid strength did not adversely affect outcomes in this analysis. Careful patient selection can yield good results in this patient population.

Indexed as

AdultAnalgesics, OpioidDecompression, SurgicalDisability EvaluationDiskectomyFemaleHumansMalePain ManagementPain MeasurementProspective StudiesRadiculopathyRetrospective StudiesSpinal Cord DiseasesSpinal FusionSurveys and QuestionnairesAnalgesics, OpioidACDF = anterior cervical discectomy and fusioncervical arthroplastycervical fusionIDE = investigational device exemptionMCS = Mental Component SummarynarcoticNDI = Neck Disability IndexopioidpainPCS = Physical Component SummarySF-36 = 36-Item Short-Form Health SurveyTDA = total disc arthroplasty

Identifiers

PMID26140401
PMCPMC4701382
OpenAlexW1917733639

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.