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Are exercise and physical therapy common forms of conservative management in the year prior to lumbar spine surgery?
Archives of Physical Medicine and Rehabilitation ( IF 3.6 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.apmr.2020.04.006
Jessica A Carrignan 1 , Richard Tyler Simmet 1 , Matthew Coddington 1 , Norman W Gill 2 , Tina A Greenlee 3 , Randall McCafferty 4 , Daniel I Rhon 5
Affiliation  

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: 411 patients undergoing surgery between 1 January 2014 and 31 December 2015, identified retrospectively through the Surgical Scheduling System (S3) based on procedure type (fusion, laminectomy, arthroplasty, vertebroplasty, and discectomy). INTERVENTIONS Elective lumbar spine surgery MAIN OUTCOMES: Healthcare utilization variables present during the full 12 months prior to surgery, that 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 (SD 11.7) years and 32.4% were female. In the year prior to surgery, 143 (34.8%) had a physical therapy plan of care, 140 (34.1%) had at least one visit that included exercise therapy, and only 60 (14.6%) had a minimum of 6 exercise therapy visits. However, 347 (84.4%) received at least one opioid prescription fill (mean of 6.1 unique fills). CONCLUSION Prior to elective lumbar spine surgery, opioid prescriptions were common but physical therapy services and exercise therapy utilization occurred infrequently.

中文翻译:

在腰椎手术前一年,运动和物理治疗是常见的保守治疗形式吗?

目的 量化和比较脊柱手术前一年阿片类药物、运动疗法和物理疗法的使用情况。设计 手术和索赔数据的回顾性队列 设置:在布鲁克陆军医疗中心看到的军事卫生系统的受益人 参与者:2014 年 1 月 1 日至 2015 年 12 月 31 日期间接受手术的 411 名患者,通过基于手术类型(融合术、椎板切除术、关节成形术、椎体成形术和椎间盘切除术)。干预 择期腰椎手术 主要结果:手术前整整 12 个月的医疗保健利用变量,包括物理治疗服务和就诊运动治疗或手动治疗程序和阿片类药物处方。结果参与者的平均年龄为 44.8 岁(SD 11. 7) 年和 32.4% 是女性。在手术前一年,143 人 (34.8%) 有物理治疗护理计划,140 人 (34.1%) 至少有一次包括运动疗法的就诊,只有 60 (14.6%) 人至少有 6 次运动疗法就诊. 然而,347 (84.4%) 人接受了至少一种阿片类药物处方填充(平均 6.1 次独特填充)。结论 在择期腰椎手术之前,阿片类药物处方很常见,但物理治疗服务和运动治疗的使用很少发生。
更新日期:2020-08-01
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