Impact of Preoperative Cannabis Use on Clinical Outcomes of Spinal Fusion—Systematic Review and Meta-analysis

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To explore the impact of preoperative cannabis use on perioperative outcomes of spinal fusion procedures. SUMMARY OF BACKGROUND DATA: Opioid use disorder is a growing problem, especially in the United States. Cannabis use is increasingly being adopted as an alternative method of pain management. However, it remains unclear how a history of preoperative cannabis use impacts opioid consumption, length of hospitalization, or perioperative complications in spinal fusion procedures. METHODS: The authors searched PubMed, Scopus, Web of Science, and Cochrane Library for studies where outcomes of spinal fusion were compared between patients preoperatively exposed and nonexposed to active cannabis use. RESULTS: A total of 7 retrospective studies and 1920 patients (386 cannabis users) were included. Significant increase in in-hospital opioid use (MD 58.84 MME; 95% CI: 29.75-87.93; P