Regional Variation in Opioid Use After Lumbar Spine Surgery

•Retrospective observational study of 13,257 patients who underwent 1, 2, or 3-level lumbar decompression and fusions surgery.•Over the 6-month preoperative period, 51.6 opioid pills were billed by opioid users monthly.•During the 2-year period after surgery, an average of 33.6 opioid pills were billed by opioid users monthly.•Receiving treatment in the South or West was independently associated with prolonged >1 year) opioid use after index surgery.•Regional variation in opioid use may exist after lumbar fusion surgery.