Opioid Dose Reduction Vis-à-Vis Lumbar Medial Branch Intervention

Area of Science:

• Pain Medicine
• Interventional Pain Management
• Spine Surgery

Background:

• Lumbar facet arthropathy (LFA) is a degenerative condition causing chronic low back pain, particularly in individuals over 40.
• Osteoarthritis-like changes, including bony overgrowth and synovial cysts, characterize LFA.
• The L4/L5 and L5/sacral junctions are most commonly affected in the lumbar spine.

Purpose of the Study:

• To investigate the association between lumbar medial branch blocks (LMBBs) and radiofrequency ablations (RFAs) and the reduction in prescription opioid use.
• To evaluate the effectiveness of LMBBs and RFAs in managing pain associated with LFA.

Main Methods:

• A retrospective cohort study of 526 patients with documented LFA was conducted.
• Patients underwent LMBB, RFA, or a combination of both procedures.
• Morphine-equivalent opioid prescriptions were compared before and after the interventions using a paired t-test.

Main Results:

• Statistically significant reductions in prescription opioid use were observed after LMBB or combined LMBB and RFA procedures.
• Patients undergoing LMBB showed a mean reduction of 4.06 mg in opioid equivalence dose.
• Patients receiving both LMBB and RFA experienced a greater mean reduction of 6.10 mg.

Conclusions:

• LMBB and RFA procedures are effective in reducing prescription opioid use in patients with LFA.
• The combination of LMBB and RFA may offer enhanced reduction in opioid consumption.
• These interventions show potential for decreasing pain and the associated healthcare burden of LFA.