Jessica A Carrignan1, Richard Tyler Simmet1, Matthew Coddington1, Norman W Gill2, Tina A Greenlee3, Randall McCafferty4, Daniel I Rhon5. 1. United States Army-Baylor Doctoral Program in Physical Therapy, Joint Base San Antonio-Fort Sam, Houston, Texas. 2. United States Army-Baylor Doctoral Program in Physical Therapy, Joint Base San Antonio-Fort Sam, Houston, Texas; Army Medical Department Center & School, Joint Base San Antonio-Fort Sam, Houston, Texas. 3. Center for the Intrepid, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam, Houston, Texas. 4. Department of Neurosurgery, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam, Houston, Texas. 5. United States Army-Baylor Doctoral Program in Physical Therapy, Joint Base San Antonio-Fort Sam, Houston, Texas; Center for the Intrepid, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam, Houston, Texas; Physical Performance Service Line, G 3/5/7, US Army Office of the Surgeon General, Falls Church, Virginia. Electronic address: daniel.i.rhon.ctr@mail.mil.
Abstract
OBJECTIVE: To quantify and compare utilization of opioids, exercise therapy, and physical therapy in the year before spine surgery. DESIGN: A retrospective cohort of surgical and claims data. SETTING: Beneficiaries of the Military Health System seen at Brooke Army Medical Center PARTICIPANTS: Patients (N=411) undergoing surgery between January 1, 2014, and December 31, 2015, identified retrospectively through the Surgical Scheduling System (S3) based on procedure type (fusion, laminectomy, arthroplasty, vertebroplasty, and diskectomy). INTERVENTIONS: Elective lumbar spine surgery. MAIN OUTCOME MEASURES: Health care utilization variables present during the full 12 months before surgery, which included physical therapy services and visits for exercise therapy or manual therapy procedures and opioid prescriptions. RESULTS: The mean age of participants was 44.8±11.7 years and 32.4% were female. In the year before surgery, 143 (34.8%) patients had a physical therapy plan of care, 140 (34.1%) had at least 1 visit that included exercise therapy, and only 60 (14.6%) had a minimum of 6 exercise therapy visits. However, 347 (84.4%) patients received at least 1 opioid prescription fill (mean of 6.1 unique fills). CONCLUSIONS: Before elective lumbar spine surgery, opioid prescriptions were common but physical therapy services and exercise therapy utilization occurred infrequently. Published by Elsevier Inc.
OBJECTIVE: To quantify and compare utilization of opioids, exercise therapy, and physical therapy in the year before spine surgery. DESIGN: A retrospective cohort of surgical and claims data. SETTING: Beneficiaries of the Military Health System seen at Brooke Army Medical Center PARTICIPANTS: Patients (N=411) undergoing surgery between January 1, 2014, and December 31, 2015, identified retrospectively through the Surgical Scheduling System (S3) based on procedure type (fusion, laminectomy, arthroplasty, vertebroplasty, and diskectomy). INTERVENTIONS: Elective lumbar spine surgery. MAIN OUTCOME MEASURES: Health care utilization variables present during the full 12 months before surgery, which included physical therapy services and visits for exercise therapy or manual therapy procedures and opioid prescriptions. RESULTS: The mean age of participants was 44.8±11.7 years and 32.4% were female. In the year before surgery, 143 (34.8%) patients had a physical therapy plan of care, 140 (34.1%) had at least 1 visit that included exercise therapy, and only 60 (14.6%) had a minimum of 6 exercise therapy visits. However, 347 (84.4%) patients received at least 1 opioid prescription fill (mean of 6.1 unique fills). CONCLUSIONS: Before elective lumbar spine surgery, opioid prescriptions were common but physical therapy services and exercise therapy utilization occurred infrequently. Published by Elsevier Inc.