Interventional treatment of vertebral compression fractures may decrease opioid use
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Published results showed a significant proportion of patients with vertebral compression fractures had decreased or discontinued opioid prescription fills, as well as reduced payer costs, after interventional treatment.
Using a large, nationally representative insurance-claims database, researchers analyzed clinical characteristics, opioid prescription patterns and payer costs among patients with vertebral compression fractures who underwent either balloon kyphoplasty (BKP; n=6,656) or vertebroplasty (VP; n=2,189). Researchers began evaluation 6 months prior to surgery through 7-month follow-up that included a 30-day, postoperative medication washout.
Results showed 75% of patients used opioids, of whom 48.7% discontinued opioid medication and 8.4% reduced prescription fills vs. preoperative baseline. Researchers found older age, baseline diagnosis of osteoporosis and baseline use of muscle relaxants were associated with decreased or discontinued opioid prescription fills after vertebral augmentation, while presence of more comorbidities was associated with increased opioid prescription fills. Researchers noted patients who decreased or discontinued opioid prescription fills after vertebral augmentation had significantly reduced average all-cause payer costs compared with baseline. However, patients who maintained, increased or started new opioid prescription fills after vertebral augmentation had greater average all-cause payer costs in the follow-up period, according to results.
“Considering the known clinical risks of unaddressed [vertebral compression fracture] VCF, the benefits of minimizing opioid use in the elderly and the economic benefit of reducing all-cause payer costs, our findings add to the argument favoring vertebral augmentation — whether BKP or VP — over [conservative medical management] as a treatment strategy to address VCF,” the authors wrote.
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