Mark,
Very interesting and enlightening article. Thanks for posting this.
This is a discussion on Pain meds causing deaths after spinal fusion within the Pain Management forums, part of the General Spine Discussion Forums category; I found this interesting article regarding deaths following spinal fusions as a result of opiate overdose. Its not hard to ...
I found this interesting article regarding deaths following spinal fusions as a result of opiate overdose. Its not hard to be a statistic when the pain is unbearable after surgery as U will often do anything to get out of pain. Hopefully this may help others not become a statistic.
Pain Meds Are Most Common Cause Of Death After Spinal Fusion Surgery: Middle-Aged Men With Disk Degeneration At Highest Risk
Pain Meds Are Most Common Cause Of Death After Spinal Fusion Surgery: Middle-Aged Men With Disk Degeneration At Highest Risk
Main Category: Neurology / Neuroscience
Also Included In: Back Pain; Pain / Anesthetics; Clinical Trials / Drug Trials
Article Date: 02 Apr 2009 - 70 PDT
Pain medications are involved in more than 20 percent of deaths occurring in the years after spinal fusion surgery for low back pain, reports a study in the April 1 issue of Spine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.
The risk of analgesic-related death is highest among patients with degenerative disc disease (DDD) especially men aged 45 to 54, according to the new research, led by Dr. Sham Maghout Juratli of Wayne State University School of Medicine, Detroit.
Of 2,378 workers' compensation patients who underwent spinal fusion surgery in Washington State between 1994 and 2001, 103 had died by 2004. The researchers analyzed the cause of death for each patient who died.
Analgesics Involved in 21 Percent of Deaths
The rate of death within three years after spinal fusion surgery was 1.9 percent. Deaths involving pain medications were the single most common category, accounting for 21 percent of all deaths. Of 22 analgesic-related deaths, 19 were accidental overdoses and three were suicides. Overall, nearly one percent of workers who underwent spinal fusion died of analgesic poisoning.
Although other diseases like cancer or heart disease combined to cause more deaths, analgesic-related deaths were the main cause of potential life-years lost. That's because younger patients were more likely to die of analgesic poisoning, whereas older patients were more likely to die of other causes.
Workers whose back pain was primarily caused by DDD were at elevated risk of analgesic-related death nearly three times higher than those with other diagnoses. The risk of death due to pain medications was highest among men aged 45 to 54 who had DDD more than seven times higher than for other groups.
The risk of death in the first three months after spinal fusion surgery was 0.29 percent. This risk was highest for patients who were undergoing a second spinal fusion procedure.
The use of spinal fusion (also called lumbar fusion) is growing rapidly, despite a lack of agreement over which patients should undergo the procedure. This is of special concern because spinal fusion carries a higher risk of complications than other, less extensive surgical procedures. Although the initial risk of death is low, few studies have looked at the mortality rate beyond the first few months after spinal fusion.
The new results raise concern about the long-term risk of death after spinal fusion, especially deaths related to pain medications. The deaths reflect the high use of opioid (narcotic) analgesics by patients with back pain, despite the lack of strong evidence for their effectiveness.
"Analgesic-related deaths are responsible for more deaths and more potential life lost among workers who underwent spinal fusion than any other cause," according to Dr. Juratli and colleagues. They believe that initial efforts to reduce analgesic-related deaths should focus on patients with DDD, especially men.
Mark,
Very interesting and enlightening article. Thanks for posting this.
Dave
Diagnosed with DDD in Nov, 2007. MRI, EMG
C3/4 C4/5 C5/6 C6/7
Surgery 06.04.08--C5/6 and C6/7 w/Prodisc
C4/5 deterioration progressing quickly
MRI on lumbar shows disc herniation at L5/S1, stenosis at L3/4, L4/5, spondylosis and DDD at L2 through S1 in July, 2009
Nerve Root, Facet Injections and Epidural every 3 months. Ongoing treatment for continued degeneration.
Very interesting... I would like to see a study where they evaluate the risks of overdose deaths if nothing is done, seems like it would be higher.
"The deaths reflect the high use of opioid (narcotic) analgesics by patients with back pain, despite the lack of strong evidence for their effectiveness."
I highly disagree with this statement. I don't know how anyone can say a lack of evidence for their effectiveness, when they do exactly what they are supposed to, take you out of pain.
31 years old- 1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!Mommy to Emma- 8 years, Ava- 6 years & had baby Eli after ADR, via c-section on March 25, 2011, completely pain free still!
Yes, very interesting article Mark. Thank-you for posting it as well. And I also disagree with that statement too Kathy. Where are these bozos coming from?![]()
• January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
• June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
• April 2006 right hip, labral tear and repair
• April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
• July 2, 2008 ALIF & Laminectomy @ L6/S1
• July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
• August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
• March 10, 2009 Right SI Joint Fusion
• April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
• September 30, 2010 lumbar facet rhizotomy
• December 9, 2010 12 bilateral lumbar trigger point and steroid injections
• December 23, 2010 12 more bilateral trigger point injections w/o steroid
• February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Mark, thanks for sharing this eye-opening article.
Justin Averna
Founder & President, Spine Patient Society™
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003: 2-Level ProDisc® L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
Mark,
This is an important article that we should all be aware of.
-Dave
Discectomy/Laminotomy, 1999
L4-S1 DDD, 10/06
Stalif Fusion L5-S1, 3/07
Intrepid Fusion L4-L5, 7/08
Increasing pain since solid fusing, 1/09
Bilateral Transforaminal Injections 3/09
Facet Joint Injections (L3-S1) 4/09
RF Ablation (Medial Branch) 5/09
CT Scan, MRI w/ contrast (no new info) 5/09
Latest:
- I wake up with no pain
- Stand/sit for 15 mins., pinching pain begins
- Pain at center, core L4-L5
- Lying down, pulsing/throbbing pain for 2-3 hours
- Taking 6-8 Norcos/day
SCS Implant 8/31/09
BTW, When looking at this thread, the Google Ad-Aware software had several ads for "Free Death Records Lookup!"
Discectomy/Laminotomy, 1999
L4-S1 DDD, 10/06
Stalif Fusion L5-S1, 3/07
Intrepid Fusion L4-L5, 7/08
Increasing pain since solid fusing, 1/09
Bilateral Transforaminal Injections 3/09
Facet Joint Injections (L3-S1) 4/09
RF Ablation (Medial Branch) 5/09
CT Scan, MRI w/ contrast (no new info) 5/09
Latest:
- I wake up with no pain
- Stand/sit for 15 mins., pinching pain begins
- Pain at center, core L4-L5
- Lying down, pulsing/throbbing pain for 2-3 hours
- Taking 6-8 Norcos/day
SCS Implant 8/31/09
I wonder if this is a reflection on the effectiveness of fusions, and if it will change with the increased use of ADRs?
I suffered a great deal during my recent discogram and dye injections because they were too afraid of respiratory arrest from giving me any more pain medication. At the time, well, I wouldn't have complained
But there are good points in that article as well as the one you pointed out, Kathy.
Severe compression of spinal cord, flaval ligament, etc. at C4/5 & 5/6.
Herniation and compression, at L3/4 to L5/S1 plus spondylosis at the latter level. Severe allergy to most metals.
Three level surgery in Brazil with Dr. Luiz Pimenta on March 17/2010 using non-metal appliances. L5/S1-PEEK cage, ALIF; L4/5-PEEK cage, XLIF; C5/6-NuVasive NeoDisc. Three separate approaches, two minimally invasive. Currently minor residual back pain, from SI ligament and still overdoing things. Therapy and chiropractic treatments helping immensely. Gone from being almost bedridden to near normal activities including gardening. Life is gooooood!
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