Spine Treatment Appraisal Report (STAR): Does Marijuana Use Affect Postoperative Outcomes in Patients Receiving Transforaminal Lumbar Interbody Fusion (TLIF)?

Abstract

Jakoi AM, Kirchner GJ, Kerbel YE, Iorio JA, Khalsa AS. The effects of marijuana use on lumbar spinal fusion. Spine (Phila Pa 1976). 2020;45(9):629-634.

Study Type

Study Quality:

Overall Risk of Bias Rating

Visual Abstract

Why Is This Study an Important Topic?

Both the rate of lumbar spinal fusion and the use of medical and recreational marijuana continue to increase in the USA. Unlike nicotine use, the effect of preoperative cannabinoid use on postoperative outcomes is not well documented.

What Was the Primary Clinical Question?

In patients who undergo TLIF, does daily preoperative marijuana use affect postoperative outcomes?

Study Characteristics

Population:	Included: 1- or 2-level TLIF with local autograft and demineralized bone matrix Excluded: Trauma, malignancy, prior lumbar procedure
Exposure:	Marijuana use (smoking or ingesting) ≥ 1x/day (n = 50, mean age = 53 years, 54% male)
Non-exposure:	No marijuana use (n = 52, mean age = 62 years, 48% male)
Outcomes:	ODI; fusion; return to OR within 90 days; revision of index procedure
Time:	Mean 17 months, range 12-25

Results

Result 1. ODI

Results 2. Revision, Return to Operating Room, Nonunion

How Will This Affect the Care of My Patients?

This study suggests that lumbar spinal fusion patients who use marijuana have similar postoperative function, risks of returning to the operating room and need for revision surgery compared with patients who do not use marijuana.