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Erschienen in: Current Pain and Headache Reports 10/2016

01.10.2016 | Other Pain (N Vadivelu and A Kaye, Section Editors)

Utilization of Facet Joint and Sacroiliac Joint Interventions in Medicare Population from 2000 to 2014: Explosive Growth Continues!

verfasst von: Laxmaiah Manchikanti, Joshua A. Hirsch, Vidyasagar Pampati, Mark V. Boswell

Erschienen in: Current Pain and Headache Reports | Ausgabe 10/2016

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Abstract

Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313.3 % per 100,000 Medicare population with an annual increase of 10.7 %. While the increases were uniform from 2000 to 2014, there were some decreases noted for facet joint interventions in 2007, 2010, and 2013, whereas for sacroiliac joint injections, the decreases were noted in 2007 and 2013. The increases were for cervical and thoracic facet neurolysis at 911.5 % compared to lumbosacral facet neurolysis of 567.8 %, 362.9 % of cervical and thoracic facet joint blocks, 316.9 % of sacroiliac joints injections, and finally 227.3 % of lumbosacral facet joint blocks.
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Zurück zum Zitat Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA. Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis. Pain Phys. 2016;16:E365–410. This manuscript compares in detail the systematic review and meta-analysis performed by Chou et al. for the Agency for Healthcare Research and Quality (AHRQ) that was published in Annals of Internal Medicine. This manuscript shows the deficiencies in the design, methodologic quality assessment, and grading of evidence in the manuscript by Chou et al. and how their conclusions lack clinical relevance. Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA. Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis. Pain Phys. 2016;16:E365–410. This manuscript compares in detail the systematic review and meta-analysis performed by Chou et al. for the Agency for Healthcare Research and Quality (AHRQ) that was published in Annals of Internal Medicine. This manuscript shows the deficiencies in the design, methodologic quality assessment, and grading of evidence in the manuscript by Chou et al. and how their conclusions lack clinical relevance.
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79.•
Zurück zum Zitat Manchikanti L, Nampiaparampil DE, Manchikanti KN, Falco FJE, Singh V, Benyamin RM, et al. Comparison of the efficacy of saline, local anesthetics, and steroids in epidural and facet joint injections for the management of spinal pain: a systematic review of randomized controlled trials. Surg Neurol Int. 2015;6:S194–235. This manuscript shows the comparative efficacy of local anesthetics with or without steroids in managing chronic spinal pain with epidural and facet joint injections. This manuscript showed overwhelmingly the effectiveness of bupivacaine alone in managing facet joint pain with no significant difference when steroids were added.CrossRefPubMedPubMedCentral Manchikanti L, Nampiaparampil DE, Manchikanti KN, Falco FJE, Singh V, Benyamin RM, et al. Comparison of the efficacy of saline, local anesthetics, and steroids in epidural and facet joint injections for the management of spinal pain: a systematic review of randomized controlled trials. Surg Neurol Int. 2015;6:S194–235. This manuscript shows the comparative efficacy of local anesthetics with or without steroids in managing chronic spinal pain with epidural and facet joint injections. This manuscript showed overwhelmingly the effectiveness of bupivacaine alone in managing facet joint pain with no significant difference when steroids were added.CrossRefPubMedPubMedCentral
80.
Zurück zum Zitat Manchikanti L, Kaye AD, Manchikanti KN, Boswell MV, Pampati V, Hirsch JA. Efficacy of epidural injections in the treatment of lumbar central spinal stenosis: a systematic review. Anesth Pain Med. 2015;5:e23139.PubMedPubMedCentral Manchikanti L, Kaye AD, Manchikanti KN, Boswell MV, Pampati V, Hirsch JA. Efficacy of epidural injections in the treatment of lumbar central spinal stenosis: a systematic review. Anesth Pain Med. 2015;5:e23139.PubMedPubMedCentral
81.
Zurück zum Zitat Manchikanti L, Singh V, Pampati V, Smith HS, Hirsch JA. Analysis of growth of interventional techniques in managing chronic pain in Medicare population: a 10-year evaluation from 1997 to 2006. Pain Phys. 2009;12:9–34. Manchikanti L, Singh V, Pampati V, Smith HS, Hirsch JA. Analysis of growth of interventional techniques in managing chronic pain in Medicare population: a 10-year evaluation from 1997 to 2006. Pain Phys. 2009;12:9–34.
Metadaten
Titel
Utilization of Facet Joint and Sacroiliac Joint Interventions in Medicare Population from 2000 to 2014: Explosive Growth Continues!
verfasst von
Laxmaiah Manchikanti
Joshua A. Hirsch
Vidyasagar Pampati
Mark V. Boswell
Publikationsdatum
01.10.2016
Verlag
Springer US
Erschienen in
Current Pain and Headache Reports / Ausgabe 10/2016
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-016-0588-2

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