Revision Lumbar Fusion Patients Exhibit Higher Long-Term Opioid and Gabapentinoid Needs Despite Similar Early Postoperative Use

STUDY DESIGN: Retrospective Cohort. OBJECTIVE: This study aimed to: (1) compare opioid use between primary and revision fusion patients; (2) evaluate differences in non-opioid analgesic use; and (3) identify risk factors of long-term opioid consumption. SUMMARY OF BACKGROUND DATA: Preoperative opioid exposure and revision surgery are recognized risk factors for prolonged postoperative opioid use after lumbar fusion, yet long-term data remain limited. METHODS: Patients who underwent elective 1-3 level lumbar spine fusion between were retrospectively identified and chart reviewed (2018-2023). Opioid and non-opioid prescription data was extracted from the state prescription drug monitoring program (PDMP) at 30 days, 90 days, 1 year, and 2 years. Patients were stratified into primary versus revision fusion cohorts and compared using bivariate and multivariable analyses. RESULTS: A total of 1,938 patients were analyzed (1,498 primary, 440 revision). Revision patients had greater preoperative opioid morphine milligram equivalent (MME) burden (953 vs. 334, P