PMID- 35710730
OWN - NLM
STAT- Publisher
LR  - 20240216
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 16
IP  - 4
DP  - 2022 Jun 16
TI  - The Effect of State-Level Prescription Opioid Legislation on Patient Outcomes 
      After Lumbar Tubular Microdecompression.
PG  - 720-6
LID - 8310 [pii]
LID - 10.14444/8310 [doi]
AB  - BACKGROUND: In the United States, a statewide legislation titled the Strengthen 
      Opioid Misuse Prevention (STOP) Act was enacted in 2017 to limit prescription 
      opioid use and reduce dependence. The impact of state legislation curbing opioid 
      prescription on outcomes after spine surgery is unknown. STUDY DESIGN: Case 
      series. METHODS: Data from consecutive patients undergoing lumbar tubular 
      microdecompression for symptomatic lumbar spine stenosis from June 2016 to June 
      2019 were retrospectively analyzed. Cases between June 2016 and December 2017 
      represent the group before the STOP act (pre-STOP), while cases between January 
      2018 and June 2019 represent the group after legislation enactment (post-STOP). 
      Preoperative and postoperative patient functional scores including the 
      EuroQol-Five Dimensions Index, Oswestry Disability Index (ODI), and the visual 
      analog scale (VAS) for back and leg pain were compared between both groups. The 
      meaningful clinically important difference (MCID) was calculated for each score 
      and was compared between both groups as well. RESULTS: A total of 147 patients 
      met inclusion criteria, with 86 in the pre-STOP group and 61 in the post-STOP 
      group. Analysis of postoperative scores demonstrated statistically lower VAS leg 
      pain score averages in the post-STOP group (P < 0.05). Higher trends in achieving 
      MCID among the post-STOP group were observed; however, the differences between 
      both groups were not statistically significant (P > 0.05 for all). Additionally, 
      there were no statistical differences in rates of unplanned pain-related clinic 
      visits and emergency department (ED) visits, as well as no differences in the 
      number of pain-related calls within 90 days after surgery between both groups. 
      CONCLUSION: The enactment of state legislation to curb the prescribing of opioids 
      for postoperative pain did not negatively affect the rate of achieving clinically 
      meaningful outcomes among patients undergoing lumbar tubular microdecompression 
      for spinal stenosis. Additionally, decreasing the amount of opioids prescribed 
      for postoperative pain does not increase the number of unplanned clinic or ED 
      visits due to pain within 90 days after surgery.
CI  - This manuscript is generously published free of charge by ISASS, the 
      International Society for the Advancement of Spine Surgery. Copyright (c) 2022 
      ISASS. To see more or order reprints or permissions, see http://ijssurgery.com.
FAU - Beck, Edward C
AU  - Beck EC
AD  - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, 
      USA ecbeck@wakehealth.edu.
FAU - White, Jonathan C
AU  - White JC
AD  - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, 
      USA.
FAU - Gowd, Anirudh K
AU  - Gowd AK
AD  - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, 
      USA.
FAU - Luo, Tianyi D
AU  - Luo TD
AD  - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, 
      USA.
FAU - Edge, Carl
AU  - Edge C
AD  - Department of Orthopedic Surgery, Virginia Commonwealth University, Richmond, VA, 
      USA.
FAU - Knio, Ziyad O
AU  - Knio ZO
AD  - Department of Anesthesiology, University of Virginia Health System, 
      Charlottesville, VA, USA.
FAU - O'Gara, Tadhg J
AU  - O'Gara TJ
AD  - Department of Orthopedic Surgery, Wake Forest Baptist Health, Winston-Salem, NC, 
      USA.
AD  - Department of Neurosurgery Surgery, Wake Forest Baptist Health, Winston-Salem, 
      NC, USA.
LA  - eng
PT  - Journal Article
DEP - 20220616
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC9421206
OTO - NOTNLM
OT  - MCID
OT  - microdiscectomy
OT  - opioid crisis
OT  - patient-reported outcomes
COIS- Declaration of Conflicting Interests: The authors report no conflicts of interest 
      in this work.
EDAT- 2022/06/18 06:00
MHDA- 2022/06/18 06:00
PMCR- 2022/06/15
CRDT- 2022/06/17 00:07
PHST- 2022/06/17 00:07 [entrez]
PHST- 2022/06/18 06:00 [pubmed]
PHST- 2022/06/18 06:00 [medline]
PHST- 2022/06/15 00:00 [pmc-release]
AID - 8310 [pii]
AID - IJSSURGERY-D-21-00152 [pii]
AID - 10.14444/8310 [doi]
PST - aheadofprint
SO  - Int J Spine Surg. 2022 Jun 16;16(4):720-6. doi: 10.14444/8310.