Trends in opioid use following balloon kyphoplasty or vertebroplasty for the treatment of vertebral compression fractures

• Main Authors: Gasquet, N. (Author), Gilligan, C.J (Author), Hirsch, J.A (Author), Janardhanan, D. (Author), Ni, W. (Author), Quinn, M. (Author), Ricker, C. (Author)
• Format: Article
• Language: English
• Published: Springer Science and Business Media Deutschland GmbH 2022
• Subjects: adverse event; aged; Aged; Analgesics, Opioid; Balloon kyphoplasty; compression fracture; female; Female; Fractures, Compression; fragility fracture; human; Humans; kyphoplasty; Kyphoplasty; male; Male; narcotic analgesic agent; Opioids; Osteoporotic Fractures; percutaneous vertebroplasty; procedures; Retrospective Studies; retrospective study; Spinal Fractures; spine fracture; treatment outcome; Treatment Outcome; Vertebral compression fractures; Vertebroplasty
• Online Access: View Fulltext in Publisher

 Summary: This retrospective analysis of insurance claims evaluated real-world trends in prescription fills among patients treated with balloon kyphoplasty (N = 6,656) or vertebroplasty (N = 2,189) following diagnosis of vertebral compression fracture. Among those with evidence of opioid use, nearly half of patients discontinued or reduced prescription fills relative to pre-operative levels. Introduction: Vertebral compression fractures (VCF) are associated with debilitating pain, spinal misalignment, increased mortality, and increased healthcare-resource utilization in elderly patients. This study evaluated the effect of balloon kyphoplasty (BKP) or vertebroplasty (VP) on post-procedure opioid prescription fills and payer costs in patients with VCF. Methods: This was a retrospective analysis of a large, nationally representative insurance-claims database. Clinical characteristics, opioid prescription patterns, and payer costs for subjects who underwent either BKP or VP to treat VCF were evaluated beginning 6 months prior to surgery through 7-month follow-up that included a 30-day, postoperative medication washout. Patient demographics, changes in opioid utilization, and payer costs were analyzed. Results: A total of 8,845 patients met eligibility criteria (75.3% BKP and 24.7% VP) with a mean of age 77 and 74% female. Among the 75% of patients who used opioids, 48.7% of patients discontinued opioid medication and 8.4% reduced prescription fills versus preoperative baseline. Patients who reduced or discontinued prescriptions exhibited a decrease in all-cause payer costs relative to pre-intervention levels, which was a significantly greater change relative to patients with no change, increase, or new start of opioids. Conclusions: Interventional treatment for VCF was associated with decreased or discontinued opioid prescription fills and reduced payer costs in follow-up in a significant proportion of the study population. Reduction of opioid-based harms may represent a previously unrecognized benefit of vertebral augmentation for VCF, especially in this elderly and medically fragile population. © 2021, The Author(s).