General Session: Innovative Technologies I - Hall F

Presented by: K. Cardinal

Author(s):

B. Haws(1), B. Khechen(1), F. Hijji(1), A. Narain(1), K. Cardinal(1), J. Guntin(1), N. Shoshana(1), K. Singh(1)

(1) Rush University Medical Center, Orthopaedic Surgery, Chicago, IL, United States

Abstract

Introduction: American Society of Anesthesiologists Score (ASA) has previously been associated with increased rates of postoperative complications and direct costs after spinal surgery. To the authors' knowledge, no studies have examined the association between ASA Score and inpatient pain and narcotics utilization after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Objective: To examine the association between ASA score and inpatient pain scores and narcotic consumption in patients undergoing MIS TLIF.

Methods: A prospectively maintained surgical database of patients who underwent a single-level, primary MIS TLIF for degenerative pathology between 2013-2016 was reviewed. Patients were grouped based on ASA Score ≤ 2 or >2. ASA score was tested for association with preoperative demographics using student's t-test and chi-squared analysis for continuous and categorical distributions, respectively. Inpatient pain scores and narcotics consumption on each postoperative day were then compared between cohorts using multivariate regression.

Results: After exclusion of patients with incomplete preoperative pain scores, a total of 293 patients were included in this analysis. Of these, 243 (82.9%) had an ASA score of ≤ 2 and 50 (17.1%) had an ASA score of >2. Patients with an ASA score >2 were older (56.16 vs 51.16 years, p=0.006), had higher rates of obesity (68.00% vs 44.44%, p=0.002), and had longer operative times (129.0 vs. 117.49 minutes, p=0.035). There were no differences in inpatient Visual Analogue Scale (VAS) pain scores or inpatient narcotic consumption between cohorts on any postoperative day (p>0.05 for each) after MIS TLIF.

Conclusions: The results of this study suggest that higher ASA scores are associated with older age and increased operative time following MIS TLIF. Despite this, there are no differences in inpatient pain or narcotics consumption based on ASA score. As such, ASA score may not be predictive of inpatient pain or narcotics utilization after MIS TLIF.

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