SRS-22r question 11 is a valid opioid screen and stratifies opioid consumption

Inclan, Paul M; CreveCoeur, Travis S.; Bess, Shay; Gum, Jeffrey L.; Line, Breton; Lenke, Lawrence G.; Kelly, Michael P.

doi:10.1007/s43390-022-00473-0

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…The minimum requirement was the availability of the two-year SRS questionnaire. Pain medication usage was assessed based on Question 11 from the SRS-22 35 . Question 11 asks about medication usage for back pain and uses the older, now less preferred term for opioids—narcotics, which for the purpose of this paper are considered synonymous.…”

Section: Methodsmentioning

confidence: 99%

“…Pain medication usage was assessed based on Question 11 from the SRS-22. 35 Question 11 asks about medication usage for back pain and uses the older, now less preferred term for opioids-narcotics, which for the purpose of this paper are considered synonymous. The possible responses are narcotics daily, narcotics weekly/less, nonnarcotics daily, non-narcotics weekly/less, or none.…”

Section: Methodsmentioning

confidence: 99%

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Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Bastrom

Kelly

Upasani

et al. 2023

Spine

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Study Design. Observational case control Objective. Evaluate the prevalence of opioid use at 2 years after surgical correction of adolescent idiopathic scoliosis (AIS) and association with preoperative mental health. Summary of Background Data. Studies of opiate use have reported that up to 80% of users began their addiction with misuse of prescription opioids. Identifying opioid use and those at risk in the AIS population is critical for optimal outcomes. Methods. A query of a multi-center prospective AIS surgical fusion registry was performed to identify patients of all curve types with responses to Question 11 on the SRS-22 questionnaire at 2 years postoperative. Question 11 asks about pain medication usage for the patient’s back with 5 specific responses; narcotics daily, narcotics weekly or less, non-narcotics daily, non-narcotics weekly/less; or none. Ordinal regression was used to evaluate the association between preoperative SRS-22 Mental Health (MH) domain scores and 2 year postoperative pain medication usage. Results. 2595 patients who underwent surgery from 2002-2019 met inclusion. The average primary curve was 56±12°, average age 14.7±3 years, and 81.5% were female. Forty (1.5%) patients reported utilizing opioids 2 years after surgery and a significant difference in preoperative MH scores was observed. Patients taking daily opioids postoperatively had the lowest median preoperative MH score (3.75), followed by non-narcotic group (4), and no medication (4.2,P<0.001). Three patients reporting opioid use postoperatively reported preoperative usage. The rate of 2 year postoperative medication use based on year of surgery demonstrated a small linear decrease in opioid use over time, with a slight increase in non-opioid daily use. Conclusion. Less than 2% of patients reported taking opioids for back pain 2 years after surgical correction of AIS. A lower Mental Health score prior to surgery may place a patient at increased risk for opioid use 2 years after surgery. An analysis of year of surgery suggests that changes in prescription practices over time may be occurring. Level of Evidence. Level 4

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Bastrom

Kelly

Upasani

et al. 2023

Spine

Self Cite

View full text Add to dashboard Cite

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Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands

Sardi,

Smith,

Gum

et al. 2024

Global Spine Journal

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Study Design Prospective multicenter database post-hoc analysis. Objectives Opioids are frequently prescribed for painful spinal conditions to provide pain relief and to allow for functional improvement, both before and after spine surgery. Amidst a current opioid epidemic, it is important for providers to understand the impact of opioid use and its relationship with patient-reported outcomes. The purpose of this study was to evaluate pre-/postoperative opioid consumption surrounding ASD and assess patient-reported pain outcomes in older patients undergoing surgery for spinal deformity. Methods Patients ≥60 years of age from 12 international centers undergoing spinal fusion of at least 5 levels and a minimum 2-year follow-up were included. Patient-reported outcome scores were collected using the Numeric Rating Scale for back and leg pain (NRS-B; NRS-L) at baseline and at 2 years following surgery. Opioid use, defined based on a specific question on case report forms and question 11 from the SRS-22r questionnaire, was assessed at baseline and at 2-year follow-up. Result Of the 219 patients who met inclusion criteria, 179 (81.7%) had 2-year data on opioid use. The percentages of patients reporting opioid use at baseline (n = 75, 34.2%) and 2 years after surgery (n = 55, 30.7%) were similar ( P = .23). However, at last follow-up 39% of baseline opioid users (Opi) were no longer taking opioids, while 14% of initial non-users (No-Opi) reported opioid use. Regional pre- and postoperative opioid use was 5.8% and 7.7% in the Asian population, 58.3% and 53.1% in the European, and 50.5% and 40.2% in North American patients, respectively. Baseline opioid users reported more preoperative back pain than the No-Opi group (7.0 vs 5.7, P = .001), while NRS-Leg pain scores were comparable (4.8 vs 4, P = .159). Similarly, at last follow-up, patients in the Opi group had greater NRS-B scores than Non-Opi patients (3.2 vs 2.3, P = .012), but no differences in NRS-Leg pain scores (2.2 vs 2.4, P = .632) were observed. Conclusions In this study, almost one-third of surgical ASD patients were consuming opioids both pre- and postoperatively world-wide. There were marked international variations, with patients from Asia having a much lower usage rate, suggesting a cultural influence. Despite both opioid users and nonusers benefitting from surgery, preoperative opioid use was strongly associated with significantly more back pain at baseline that persisted at 2-year follow up, as well as persistent postoperative opioid needs.

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SRS-22r question 11 is a valid opioid screen and stratifies opioid consumption

Cited by 2 publications

References 24 publications

Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Opioid Use Prior to Adult Spine Deformity Correction Surgery is Associated With Worse Pre- and Postoperative Back Pain and Prolonged Opioid Demands

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