ArticleJournal of spine surgery (Hong Kong)2026
Perioperative opioid prescribing concerns in anterior cervical surgery.
Article in Journal of spine surgery (Hong Kong), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Opioid prescriptions are increasingly used to treat cervical pain. This violates most opioid prescribing guidelines and is associated with worse clinical outcomes, prolonged post-operative opioid use, and dependence. This study aims to analyse the impact of preoperative opioid prescribing on perioperative and long-term opioid use following anterior cervical surgery. Methods: A retrospective cohort study of consecutive patients undergoing 1-2 level anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or hybrid procedures by a single surgeon in Melbourne, Australia (Oct 2020-Feb 2024). SafeScript data was used to quantify opioid prescribing. Outcomes included postoperative opioid use, morphine milligram equivalents (MME), complications, and patient-reported outcome measures (PROMs). Results: Sixty-one patients were identified, 28 opioid-sensitised (OS) and 33 opioid-naïve (ON). Patient demographics and complications between groups were similar. More OS patients required opioids at 6 weeks (3.0% Conclusions: OS patients undergoing anterior cervical surgery are more likely to chronically use opioids postoperatively compared to ON patients. Duration of preoperative opioid use significantly predicts prolonged postoperative use, with no corresponding improvement in PROMs.
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