1149 Can Staying Awake, Curb Opioid Intake? Comparing Opioid Use in Awake versus Sleep Minimally Invasive Transforaminal Lumbar Interbody Fusion

作者：Harshvardhan Iyer, Jesús E. Sánchez-Garavito, Jorge Rios-Zermano, Andrew P. Roberts, Juan Pablo Navarro Garcia de Llano, Adrian Safa, Loizos Michaelides, Jimena Gonzalez-Salido, Benjamin F. Gruenbaum, Elird Bojaxhi, Oluwaseun O. Akinduro, Ian A. Buchanan, Kingsley Abode-Iyamah · 发表于：Neurosurgery · 年份：2026 · DOI：10.1227/neu.0000000000003964_1149 · 研究领域：Spine and Intervertebral Disc Pathology、Opioid Use Disorder Treatment、Pain Management and Opioid Use

INTRODUCTION: Post-operative pain in patients undergoing spinal fusion surgery is difficult to manage, and opioids are the primary analgesics prescribed. Patients undergoing minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) under spinal anesthesia (SA) have been shown to experience better pain control compared to MIS-TLIFs under general anesthesia (GA). METHODS: We retrospectively studied, patients (>18 years) undergoing 1 and contiguous 2-level MIS-TLIFs without revisions performed by a single surgeon. Post-operative oral opioid use, up to 3 months post-discharge was evaluated to assess differences between the groups. After implementing a 1:1 propensity score match, each outcome variable was assessed using univariate regression. Predictor variables with a p-value < 0.2 were included for the multivariate regression. RESULTS: There was no difference between the matched groups (n = 50 patients in each group) on demographics or levels treated. Before regression analyses, mean number of post-operative opioid prescriptions (p = 0.03), mean total operating room (OR) time in minutes (p < 0.01), median length of stay (LOS) in days (p = 0.05) were significantly different. Multivariate regression showed the SMT group received 216.5 total morphine milligram equivalent more than the AMT group (95% CI = 0.7 - 432.2, p = 0.049). The SMTs received 3.8 days more opioids than the AMTs (95% CI = 0.5 to 7.1, p = 0.025). The AMTs received 0.6 less opioid prescriptions than t...