Association Between Opioid Use and Patient-Reported Outcomes in a Randomized Trial Evaluating Basivertebral Nerve Ablation for the Relief of Chronic Low Back Pain.

Authors

John D Markman
Alfred L Rhyne
Rick C Sasso
Alpesh A Patel
Wellington K Hsu
Jeffrey S Fischgrund, Beaumont Health
Avram A Edidin
Peter Vajkoczy

Document Type

Article

Publication Date

3-1-2020

Publication Title

Neurosurgery

Abstract

BACKGROUND: Chronic low back pain (CLBP) is a primary indication for opioid therapy.

OBJECTIVE: To evaluate the hypothesis that CLBP patients reporting reduced opioid use have superior functional outcomes following basivertebral nerve (BVN) radiofrequency ablation.

METHODS: This post hoc analysis from a sham-controlled trial examined short-acting opioid use from baseline through 1 yr. Opioid use was stratified into 3 groups by two blinded external reviewers. Two-sample t-tests were used to compare Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) measurements between those patients who increased or decreased their opioid usage compared to baseline.

RESULTS: Actively treated patients with decreased opioid use at 12 mo had a mean ODI improvement of 24.9 ± 16.0 (n = 27) compared to 7.3 ± 9.8 (n = 18) for patients reporting increased opioid use (P < .001). In the sham arm, the improvements in ODI were 17.4 ± 16.1 (n = 19) and 1.2 ± 14.3 (n = 5; P = .053) for the patients reporting decreased vs increased opioid usage, respectively. Actively treated patients reporting decreased opioid use had a mean improvement in VAS of 3.3 ± 2.5 (n = 27) compared to 0.6 ± 1.8 (n = 18) for patients reporting increased opioid use (P < .001). In the sham arm, the improvements in VAS were 2.5 ± 2.6 (n = 19) and 1.4 ± 1.9 (n = 5; P = .374) for patients reporting decreased vs increased opioid use, respectively.

CONCLUSION: Subjects undergoing BVN ablation who decreased opioid use had greater improvement in ODI and VAS scores compared with those reporting increased opioid usage. There is an association between functional benefit from BVN ablation and reduced opioid use.

Volume

86

Issue

3

First Page

343

Last Page

347

Recommended Citation

Markman JD, Rhyne AL, Sasso RC, Patel AA, Hsu WK, Fischgrund JS, Edidin AA, Vajkoczy P. Association Between Opioid Use and Patient-Reported Outcomes in a Randomized Trial Evaluating Basivertebral Nerve Ablation for the Relief of Chronic Low Back Pain. Neurosurgery. 2020 Mar 1;86(3):343-347. doi: 10.1093/neuros/nyz093. PMID: 31034561.

DOI

10.1093/neuros/nyz093

ISSN

1524-4040

PubMed ID

31034561