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

Autor:	Markman JD; Translational Pain Research Program Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, Rochester, New York., Rhyne AL; OrthoCarolina Spine Center, Charlotte, North Carolina., Sasso RC; Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana., Patel AA; Department of Orthopaedic Surgery and Department of Neurosurgery, Northwestern Feinberg School of Medicine, Chicago, Illinois., Hsu WK; Department of Orthopaedic Surgery and Department of Neurosurgery, Northwestern Feinberg School of Medicine, Chicago, Illinois., Fischgrund JS; Department of Orthopedic Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan., Edidin AA; Relievant Medsystems, Sunnyvale, California., Vajkoczy P; Department of Neurosurgery, Charité Universitätsmedizin, Berlin, Germany.
Jazyk:	angličtina
Zdroj:	Neurosurgery [Neurosurgery] 2020 Mar 01; Vol. 86 (3), pp. 343-347.
DOI:	10.1093/neuros/nyz093
Abstrakt:	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. (© Congress of Neurological Surgeons 2019.)
Databáze:	MEDLINE
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