title: A Nationwide Retrospective Study of Opioid Management Patterns in 2,468 Patients with Spinal Pain in Korea.
abstract: METHODS
  Retrospective patient data collection and investigator survey.
  
  
  OBJECTIVE
  To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea.
  
  
  BACKGROUND
  Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population.
  
  
  METHODS
  Patient data were collected from medical records at 34 university hospitals in Korea. Outpatients receiving opioids for pain caused by spinal disorders were included in the study. Treatment patterns, including opioid types, doses, treatment duration, outcomes, and adverse drug reactions (ADRs), were evaluated. Investigators were interviewed on their perceptions of opioid use for spinal disorders.
  
  
  RESULTS
  Among 2,468 analyzed cases, spinal stenosis (42.8%) was the most common presentation, followed by disc herniation (24.2%) and vertebral fracture (17.5%). In addition, a greater proportion of patients experienced severe pain (73.9%) rather than moderate (19.9%) or mild (0.7%) pain. Oxycodone (51.9%) and fentanyl (50.8%) were the most frequently prescribed opioids; most patients were prescribed relatively low doses. The median duration of opioid treatment was 84 days. Pain relief was superior in patients with longer treatment duration (≥2 months) or with nociceptive pain than in those with shorter treatment duration or with neuropathic or mixed-type pain. ADRs were observed in 8.6% of cases. According to the investigators' survey, "excellent analgesic effect" was a perceived advantage of opioids, while safety concerns were a disadvantage.
  
  
  CONCLUSIONS
  Opioid usage patterns in patients with spinal disorders are in alignment with international guidelines for spinal pain management. Future prospective studies may address the suitability of opioids for spinal pain treatment by using appropriate objective measurement tools.
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, Good Doctor Teun Teun Hospital, Anyang, Korea.
authors.forename: Chun-Kun
authors.initials: CK
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
authors.forename: Kyu-Jung
authors.initials: KJ
authors.lastname: Cho
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kyoung Hyo
authors.initials: KH
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Jin-Hyok
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University Medical Center, Seoul, Korea.
authors.forename: Sung-Uk
authors.initials: SU
authors.lastname: Kuh
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Jae Chul
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Jae Hyup
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Kyu-Yeol
authors.initials: KY
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sun-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Severance Hospital, Yonsei University Health System, Seoul, Korea.
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Si-Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Anesthesia and Pain Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
authors.forename: Jae Hang
authors.initials: JH
authors.lastname: Shim
authors.affiliation: Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Son
authors.affiliation: Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Myung Ha
authors.initials: MH
authors.lastname: Yoon
authors.affiliation: Mundipharma Korea Ltd., Seoul, Korea.
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Park
keywords: Chronic pain; Opioid; Spinal diseases; Spine