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

Weir, S., Samnaliev, M., Kuo, T.-C., Tierney, T. S., Manca, A., Taylor, R. S. , Bruce, J., Eldabe, S. and Cumming, D. (2020) Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study. Journal of Orthopaedic Surgery and Research, 15(1), 127. (doi: 10.1186/s13018-020-01633-6) (PMID:32238173) (PMCID:PMC7114788)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Weir, S., Samnaliev, M., Kuo, T.-C., Tierney, T. S., Manca, A., Taylor, R. S., Bruce, J., Eldabe, S., and Cumming, D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Journal of Orthopaedic Surgery and Research
Publisher:BioMed Central
ISSN:1749-799X
ISSN (Online):1749-799X
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Journal of Orthopaedic Surgery and Research 15(1):127
Publisher Policy:Reproduced under a Creative Commons licence

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