Evidence map›Paper›PMID 40625009›Full record

ArticleNeurospine2025

Preoperative Opioid Misuse Associations With Delayed Opioid Cessation, Pain, and Negative Affect After Spine Surgery.

Jennifer M Hah, Shana C Levine, Saneel Khairnar, Luke Pirrotta, Alma Rechav Ben-Natan, Emily Tse, Gabrielle Hettie, Todd Alamin, Anand Veeravagu, Serena Hu and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurospine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Jennifer M HahDepartment of Anesthesiology, Perioperative, and Pain Medicine; Stanford University School of Medicine, Stanford, CA, USA.
Shana C LevineDepartment of Anesthesiology, Perioperative, and Pain Medicine; Stanford University School of Medicine, Stanford, CA, USA.
Saneel KhairnarDepartment of Anesthesiology, Perioperative, and Pain Medicine; Stanford University School of Medicine, Stanford, CA, USA.
Luke PirrottaDepartment of Anesthesiology, Perioperative, and Pain Medicine; Stanford University School of Medicine, Stanford, CA, USA.
Alma Rechav Ben-NatanUniversity of California, Irvine, School of Medicine, Irvine, CA, USA.
Emily TseUniversity of California, Irvine, School of Medicine, Irvine, CA, USA.
Gabrielle HettieDepartment of Anesthesiology, Perioperative, and Pain Medicine; Stanford University School of Medicine, Stanford, CA, USA.
Todd AlaminDepartment of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Anand VeeravaguDepartment of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Serena HuDepartment of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Tina Hernandez-BoussardDepartment of Biomedical Data Sciences, Stanford University School of Medicine, Stanford, CA, USA.

Funding

Integrating Tailored Postoperative Opioid Tapering and Pain Management Support for Patients on Long-Term Opioid Use Presenting for Spine Surgery (MIRHIQL)R01DA058694 · NIDA · STANFORD UNIVERSITY · PI Jennifer Hah · 2023 to 2026
$4.5M
NIDA NIH HHS R01 DA058694NIH HHS R01DA058694
6 · The paper itself

Abstract

objectivePreoperative opioid misuse is associated with worse postoperative outcomes. This prospective longitudinal cohort study evaluated the association between preoperative opioid misuse and prolonged pain and opioid use after elective spine surgery; and examined postoperative trajectories of patient-reported outcomes over one year.

methodsFifty-two patients undergoing elective spine surgery completed presurgical and weekly postoperative longitudinal assessments of pain and opioid use and monthly assessments of depression, anxiety, sleep disturbance, and physical function. Cox regression analyzed the effect of preoperative opioid misuse on time to pain and opioid cessation while linear mixed-effects models examined longitudinal changes in postoperative outcomes.

resultsAdjusting for age, sex, operative region, number of spinal levels, and any preoperative opioid use, preoperative opioid misuse (COMM-Positive) was associated with a delayed return to baseline opioid dose (hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.14-0.88; p=0.02) and delayed opioid cessation (HR, 0.25; 95% CI, 0.09-0.59; p=0.008). All patients experienced comparable reductions in current and average pain intensity, and pain interference over time. COMM-Positive patients reported a normalization of postoperative anxiety and depression 1 month after surgery with a rebound at 3 months while patients without preoperative opioid misuse remained stable over time.

conclusionPreoperative opioid misuse is a significant risk factor for delayed opioid cessation even after adjusting for preoperative opioid use, and is associated with a transient normalization of anxiety and depressive symptoms with a rebound 3 months following spine surgery. Targeted screening and risk reduction strategies are needed for patients reporting preoperative opioid misuse before spine surgery.

Indexed as

DepressionOpioid misusePain interferencePostoperative opioid usePostoperative painSpine surgery

Identifiers

PMID40625009
PMCPMC12242735

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.