Researchers conducted a prospective observational study. They sought to track daily opioid consumption and pain levels after a 1- or 2-level anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty procedure (CDA). Between March 2018 and March 2019, patients undergoing 1-level or 2-level primary ACDF or CDA were consecutively enrolled at 2 participating institutions. Patients addicted to opioids (defined as daily use for ≥6 months before surgery) were excluded. Investigators used a Health Insurance Portability and Accountability Act-compliant, an automated text-messaging system to gather daily opioid consumption and numeric pain rating scale pain levels starting on postoperative day 1. Oral morphine equivalents were transformed into “pills” (oxycodone 5 mg equivalents) to make clinical applications easier. Final survey questions were asked after 6 weeks or when the patient reported stopping using opioids. Researchers used the state prescription registry to verify refill data. Patients in the top quartile of consumption had their risk variables examined. The daily questionnaires were completed by 48 patients (84.2%) out of 57. The average age of the patients in the study was somewhere between 50.2 and 10.9 years. About 32 patients (66.7%) had ACDF and 16 (33.3%) had CDA; 64.6% had 1 level and 35.4% had 2 levels. The average number of pills taken after discharge was 6.7 (range: 0–160). The 1-level and 2-level groups did not differ in cumulative opioid use (median pill intake, 10 interquartile range: 1.3–31.3 vs 4 interquartile range: 0–18, respectively, P=0.085). After discharge, 13 patients (27.1%) did not utilize any opioids. Half of those who took opioids after discharge had stopped by postoperative day 8. Intermittent opioid usage before surgery was linked to the highest quartile of opioid intake (9.1% vs 50%, P=0.006). Because most patients only take a few opioids, patients might be given the choice of a discharge prescription for 12 oxycodone 5 mg (90 oral morphine equivalents), along with teaching on proper opioid use and disposal.
