17. The impact of preoperative cannabis on outcomes following cervical spinal fusion: a propensity score-matched analysis

Shah, Neil V.; Moattari, Cameron R.; Lavian, Joshua D.; Coste, Marine; Kim, David; Khanal, Sirish; Scollan, Joseph P.; Beyer, George A.; Morrissey, Patrick; Kim, Nathan S.; Passias, Peter G.; Lafage, Renaud; Kim, Hee Jin; Paulino, Carl B.; Schwab, Frank J.; Lafage, Virginie; Diebo, Bassel G.

doi:10.1016/j.spinee.2019.05.030

Cited by 2 publications

(3 citation statements)

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“…Our findings regarding cervical fusion resemble those of an additional retrospective cohort study in which Shah et al 22 sought to whether adverse outcomes are comparable between cannabis users and nonusers undergoing cervical fusion using SPARCS. In this analysis, baseline cannabis dependence/abuse was associated with increased 90-day readmission odds.…”

Section: Discussionsupporting

confidence: 73%

Cannabis Use Disorder Trends and Health Care Utilization Following Cervical and Lumbar Spine Fusions

Dietz,

Alkin,

Agarwal

et al. 2023

Spine

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Study Design. Retrospective cohort Objective. To identify differences in complication rates following cervical and lumbar fusion over the first postoperative year between those with and without cannabis use disorder (CUD) and to assess how CUD affects opioid prescription patterns. Summary of Background Data. Cannabis is legal for medical purposes in 36 states and recreational use in 18 states. Cannabis has multisystem effects and may contribute to transient vasoconstrictive, pro-thrombotic, and inflammatory effects. Methods. The IBM MarketScan Database (2009-2019) was used to identify patients who underwent cervical or lumbar fusions, with or without CUD. Exact match hospitalization and post-discharge outcomes were analyzed at index, 6-, and 12-months. Results. Of 72,024 cervical fusion (2.0% with CUD) and 105,612 lumbar fusion patients (1.5% with CUD), individuals with CUD were more likely to be young males with higher Elixhauser index. The cervical CUD group had increased neurological complications (3% vs 2%) and sepsis (1% vs 0%) during index hospitalization, and neurological (7% vs 5%) and wound complications (5% vs 3%) at 12-months. The lumbar CUD group had increased wound (8% vs 5%) and MI (2% vs 1%) complications at 6-months and at 12-months. For those with cervical myelopathy, increased risk of pulmonary complications were observed with CUD at index hospitalization and 12 month follow up. For those with lumbar stenosis, cardiac complications and MI were associated with CUD at index hospitalization and 12 months. CUD was associated with opiate use disorder, decreasing postoperatively. Conclusion. No differences in reoperation rates were observed for CUD groups undergoing cervical or lumbar fusion. CUD was associated with increased risk of stroke for the cervical fusion cohort, and cardiac (including MI) and pulmonary complications for lumbar fusion at index hospitalization, and 6 and 12 months postoperatively. Opiate use disorder and decreased opiate dependence following surgery also correlated with CUD.

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Section: Discussionsupporting

confidence: 73%

Cannabis Use Disorder Trends and Health Care Utilization Following Cervical and Lumbar Spine Fusions

Dietz,

Alkin,

Agarwal

et al. 2023

Spine

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“…In a recent single-center retrospective comparison of marijuana users and non-users who underwent transforaminal interbody lumbar fusion (TLIF), Jakoi et al 7 did not appreciate any significant differences in perioperative complications with a minimum 12-month follow-up. Furthermore, overall 90-day complications were similar between marijuana users and non-users who 20,21 However, none of the previous studies reported on the use of TXA in the study populations.…”

Section: Discussionmentioning

confidence: 77%

“…Furthermore, overall 90-day complications were similar between marijuana users and non-users who underwent thoracolumbar or cervical fusions in analyses of the New York Statewide Planning and Research Cooperative System between 2009 and 2013. 20 , 21 However, none of the previous studies reported on the use of TXA in the study populations.…”

Section: Discussionmentioning

confidence: 96%

Marijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery

Jakoi¹,

Kirchner

Lieber

et al. 2022

Global Spine Journal

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Study Design Retrospective cohort study Objective The purpose of this study was to evaluate safety in lumbar spinal fusion with tranexamic acid (TXA) utilization in patients using marijuana. Methods This was a retrospective cohort study involving a single surgeon’s cases of 1 to 4 level lumbar fusion procedures. Two hundred and ninety-four patients were followed for ninety days post-operatively. Consecutive patients were self-reported for daily marijuana use (n = 146) and compared to a similar cohort of patients who denied usage of marijuana (n = 146). Outcomes were collected, which included length of stay (LOS), estimated blood loss (EBL), post-operative myocardial infarction, seizures, deep venous thrombosis, pulmonary embolus, death, readmission, need for further surgery, infection, anaphylaxis, acute renal injury, and need for blood product transfusion. Results Patients in the marijuana usage cohort had similar age (58.9 years ±12.9 vs 58.7 years ±14.8, P = .903) and distribution of levels fused ( P = .431) compared to the non-usage cohort. Thromboembolic events were rare in both groups (marijuana usage: 1 vs non-usage: 2). Compared to the non-usage cohort, the marijuana usage cohort had a similar average EBL (329.9 ± 298.5 mL vs 374.5 ± 363.8 mL; P = .254). Multivariate regression modeling demonstrated that neither EBL (OR 1.27, 95% CI 0.64-2.49) nor need for transfusion (OR 1.56, 95% CI 0.43-5.72) varied between cohorts. The non-usage cohort had twice the risk of prolonged LOS compared to the marijuana usage cohort (OR 2.05, 95% CI 1.15-3.63). Conclusion Marijuana use should not be considered a contraindication for TXA utilization in lumbar spine surgery.

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17. The impact of preoperative cannabis on outcomes following cervical spinal fusion: a propensity score-matched analysis

Cited by 2 publications

References 0 publications

Cannabis Use Disorder Trends and Health Care Utilization Following Cervical and Lumbar Spine Fusions

Cannabis Use Disorder Trends and Health Care Utilization Following Cervical and Lumbar Spine Fusions

Marijuana Use is Not a Contraindication for Tranexamic Acid Utilization in Lumbar Spine Surgery

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