Impact of tramadol abuse on clinical outcome of lumbar discectomy patients'.

BACKGROUND DATA

Little data exists regarding the effect of chronic preoperative tramadol abuse on the clinical outcomes after surgery. Lumbar discectomy is a very common procedure that has a predictably high success rate for relief of radicular pain. In addition, the patient population presenting for this procedure has a high propensity for preoperative narcotic use.

PURPOSE

The study aims to identify an association between preoperative tramadol abuse and clinical outcome after lumbar discectomy.

STUDY DESIGN

A descriptive controlled, non-randomized, clinical study.

PATIENTS AND METHODS

Sixty patients underwent surgery for lumbar disc herniation. They were divided into two groups; control group and tramadol abuse group. Each group included 30 patients. They were operated between 2015 and 2016. Participants were evaluated pre-operatively and post-operatively every three months. Strict history taking regarding preoperative and postoperative pain medication utilization, operative time, hospital stay and complications were assessed. Pain was scored by a VAS for both lower limbs and back pain. The clinical outcomes were compared using the Prolo economic and functional rating scale.

RESULTS

In Tramadol abuse group, 12 (40%) continued to use tramadol after surgery. Tramadol abuse group showed worse clinical outcome parameters including worse VAS for low back pain and lower limb pain, worse Prolo economic, functional rating scale. In addition, tramadol abuse group showed significantly higher complications rate in the early post-operative and during the follow up period.

CONCLUSION

Tramadol abuse before lumbar discectomy was found to be associated with continued tramadol abuse after surgery and worse functional outcomes following surgery. Surgeons may want to counsel their patients about the potential for inferior clinical outcomes if narcotics were used before surgery.