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Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study

PURPOSE: To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery—commonly known as Failed Back Surgery Syndrome—and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy. METHODS: The UK population-based healthcare data from the Hospital Ep...

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Autores principales: Weir, Sharada, Samnaliev, Mihail, Kuo, Tzu-Chun, Tierney, Travis S., Manca, Andrea, Taylor, Rod S., Bruce, Julie, Eldabe, Sam, Cumming, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114788/
https://www.ncbi.nlm.nih.gov/pubmed/32238173
http://dx.doi.org/10.1186/s13018-020-01633-6
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author Weir, Sharada
Samnaliev, Mihail
Kuo, Tzu-Chun
Tierney, Travis S.
Manca, Andrea
Taylor, Rod S.
Bruce, Julie
Eldabe, Sam
Cumming, David
author_facet Weir, Sharada
Samnaliev, Mihail
Kuo, Tzu-Chun
Tierney, Travis S.
Manca, Andrea
Taylor, Rod S.
Bruce, Julie
Eldabe, Sam
Cumming, David
author_sort Weir, Sharada
collection PubMed
description PURPOSE: To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery—commonly known as Failed Back Surgery Syndrome—and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy. METHODS: The UK population-based healthcare data from the Hospital Episode Statistics (HES) database from NHS Digital and the Clinical Practice Research Datalink (CPRD) were queried to identify patients with PPP following lumbar spinal surgery. Rates of PPP were calculated by type of surgery (instrumented and non-instrumented). Total healthcare costs associated with the surgery and covering the 24-month period after index hospital discharge were estimated using standard methods for classifying health care encounters into major categories of health care resource utilization (i.e., inpatient hospital stays, outpatient clinic visits, accident and emergency attendances, primary care encounters, and medications prescribed in primary care) and applying the appropriate unit costs (expressed in 2013 GBP). RESULTS: Increasing the complexity of surgery with instrumentation was not associated with an increased rate of PPP. However, 2-year healthcare costs following discharge after surgery are significantly higher among patients who underwent instrumented surgery compared with decompression/discectomy. CONCLUSIONS: Although there is a not insubstantial risk of ongoing pain following spine surgery, with 1-in-5 patients experiencing PPP within 2 years of surgery, the underlying indications for surgical modality and related choice of surgical procedure do not, by itself, appear to be a driving factor.
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spelling pubmed-71147882020-04-07 Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study Weir, Sharada Samnaliev, Mihail Kuo, Tzu-Chun Tierney, Travis S. Manca, Andrea Taylor, Rod S. Bruce, Julie Eldabe, Sam Cumming, David J Orthop Surg Res Research Article PURPOSE: To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery—commonly known as Failed Back Surgery Syndrome—and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy. METHODS: The UK population-based healthcare data from the Hospital Episode Statistics (HES) database from NHS Digital and the Clinical Practice Research Datalink (CPRD) were queried to identify patients with PPP following lumbar spinal surgery. Rates of PPP were calculated by type of surgery (instrumented and non-instrumented). Total healthcare costs associated with the surgery and covering the 24-month period after index hospital discharge were estimated using standard methods for classifying health care encounters into major categories of health care resource utilization (i.e., inpatient hospital stays, outpatient clinic visits, accident and emergency attendances, primary care encounters, and medications prescribed in primary care) and applying the appropriate unit costs (expressed in 2013 GBP). RESULTS: Increasing the complexity of surgery with instrumentation was not associated with an increased rate of PPP. However, 2-year healthcare costs following discharge after surgery are significantly higher among patients who underwent instrumented surgery compared with decompression/discectomy. CONCLUSIONS: Although there is a not insubstantial risk of ongoing pain following spine surgery, with 1-in-5 patients experiencing PPP within 2 years of surgery, the underlying indications for surgical modality and related choice of surgical procedure do not, by itself, appear to be a driving factor. BioMed Central 2020-04-01 /pmc/articles/PMC7114788/ /pubmed/32238173 http://dx.doi.org/10.1186/s13018-020-01633-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Weir, Sharada
Samnaliev, Mihail
Kuo, Tzu-Chun
Tierney, Travis S.
Manca, Andrea
Taylor, Rod S.
Bruce, Julie
Eldabe, Sam
Cumming, David
Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title_full Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title_fullStr Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title_full_unstemmed Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title_short Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
title_sort persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114788/
https://www.ncbi.nlm.nih.gov/pubmed/32238173
http://dx.doi.org/10.1186/s13018-020-01633-6
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