Marijuana Increases Cervical Spine Reop Risk: New Study

When a patient uses marijuana before anterior cervical discectomy and fusion, it can increase their risk of a cervical spine reoperation, according to a new study.

The study, “Marijuana Use and its Effect on Clinical Outcomes and Revision Rates in Patients Undergoing Anterior Cervical Discectomy and Fusion,” was published in the November 15, 2022 issue of the journal Spine.

“A growing number of states have legalized recreational and/or medical marijuana, thus increasing the number of patients who report preoperative marijuana use. The effects of marijuana on clinical outcomes and patient-reported outcomes in the postoperative period are unknown,” the researchers wrote.

In their study, the Rothman Institute (Philadelphia) and Cooper Medical School (New Jersey) research team were hoping to learn what, if any, effect preoperative marijuana use had on patient-reported cervical spine surgery outcome measures and if it also had an effect on the quantity of opioid prescriptions during the postop recovery period.

The patients included in the analysis were all 18 years of age and older and had undergone primary one- to four-level anterior cervical discectomy and fusion at the researchers’ academic institution. The patients with confirmed preoperative marijuana use were compared to those without it.

Of the 240 patients, 60 had used marijuana preoperatively. Overall, the patients who used marijuana before their surgery had worse one-year patient-reported outcomes as measured by the Physical Component Scores of the Short-Form 12, Neck Disability Index, Visual Analogue Scale Arm and Visual Analogue Scale Neck.

The connection between marijuana use and patient outcomes was strong enough to be a predictor of cervical spine reoperation. It however did not independently predict improvement in Physical Component Scores of the Short-Form, Neck Disability Index, Mental Component Scores of the Short-Form, Visual Analogue Score Arm or Visual Analogue Scale Neck.

“Preoperative marijuana use increased the risk of a cervical spine reoperation after anterior cervical discectomy and fusion, but it did not significantly change the amount of postoperative opioids used or the magnitude of improvements in patient-reported outcomes,” the researchers wrote.

Study authors include Mark J. Lambrechts, M.D., Nicholas D. D’Antonio, B.S.; Gregory R. Toci, B.S., Brian A. Karamian, M.D., Dominic Farronato, B.S., Joshua Pezzulo, B.S., Jose A. Canseco, M.D., Ph.D., Barrett Woods, M.D., Alan S. Hilibrand, M.D., Christopher K. Kepler, M.D., Alexander R. Vaccaro, M.D., MBA, PhD., and Gregory R. Schroeder, M.D., all of Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Garrett Breyer, B.S. of the Cooper Medical School of Rowan University in Camden, New Jersey, also contributed to the study.