Background: Research focused on the association of opioid use disorder (OUD) on postoperative outcomes in patients undergoing primary lumbar laminectomy is lacking. This study aims to observe the impact of OUD on (1) hospital length of stay (LOS), (2) readmission rates, (3) medical complications, and (4) health care expenditures.Methods: A retrospective query was performed using a nationwide claims database from January 2005 to March 2014 for all patients who underwent lumbar laminectomy, yielding a total of 131,635 patients. The study cohort included 3515 patients with OUD, while 128,120 patients served as the comparison cohort. Multivariate binomial logistic regression analyses were used to determine the association of OUD on readmission rates and medical complications, whereas Welch's t tests were used to compare LOS and health care expenditures. A P value less than 0.001 was considered statistically significant.Results: Patients with OUD undergoing lumbar laminectomy had significantly longer hospital LOS (3.68 vs 1.13 days, P < 0.0001). Readmission rates were significantly higher (14.57% vs 7.39%, OR: 1.73, P < 0.0001) in patients who had an OUD. The study cohort was found to have higher incidence and odds (32.36% vs 9.76%, OR: 3.53, P < 0.0001) of 90-day medical complications and total global 90-day episode of care reimbursement rates ($13,635.81 vs $8131.20, P < 0.0001) compared with their counterparts.Conclusions: This study demonstrates OUD to be associated with longer hospital LOS, increased rates of 90-day readmissions, medical complications, and health care expenditures following lumbar laminectomy.Level of Evidence: 3. Clinical Relevance: Results indicate that OUD is associated with worse outcomes following lumbar laminectomy.
Trigeminal neuralgia (TN) presents with extreme pain involving one or more branches of the trigeminal nerve (CN V). Although the exact cause of TN is still unknown, most cases have been linked to neurovascular compression of the nerve at the base of the brain. Pain refractory to medications can be treated with an image-guided trigeminal nerve block. A mass compressing on the trigeminal nerve can also present in rare cases of TN. Appropriate imaging is necessary to identify the likely cause of TN and develop a treatment plan prior to any intervention. We discuss the case of an 81-year-old woman diagnosed with invasive oral squamous cell carcinoma presenting as TN.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.