Distribution and Timing of Allopathic Procedures for Patients with Spinal Pain

Introduction: Spine pain significantly reduces participation in daily activities and work-related tasks. Analyzing the distribution and timing of spine procedures administered to patients is essential for enhancing future care. This study aims to assess surgical and injection procedures with their timing for spinal pain in the Florida population, offering insights for patients and practitioners on current treatment trends.

Methods: Data collected within the OneFlorida+ data repository were retrospectively reviewed to identify patients (18+ years) that had both a spinal pain diagnosis and a spinal surgery (fusion or non-fusion) or spinal injection between 2012-2022. Treatment codes used to classify fusion and non-fusion surgeries were determined by a board-certified neurosurgeon based on common coding practices. Multiple procedural codes were present for each patient, however, patients with traumatic or neoplasm spine-pain diagnoses were excluded. An analysis was conducted to assess the following metrics: 1) duration from diagnosis to first procedure, 2) duration from diagnosis to first injection, 3) total number of procedures including surgeries and injections, and 4) the percentages of surgeries and injections.

Results: A total of 12,450 patients (age: 59.1±13.1yrs) were identified. Of these patients, 9,206 (73.9%) had 1 procedure (Injection: 4,548; Fusion: 4,223; Non-Fusion: 435), while 3,244 (26.1%) had two or more spinal procedures (Injections: 1,775; Fusions: 348; Non-Fusions: 47; Combination of procedures: 1,074). There was a total of 20,465 spinal procedures completed across the 12,450 patients (Injections: 64.9%; Fusions: 28.7%; and Non-Fusions: 6.3%). The median [Q25, Q75] time from diagnosis until the first procedure was 4yrs [2,6] for injections, 2yrs [0,5] for fusion, 3yrs [1,5] for non-fusions.

Conclusion : The prevalence of surgery is larger than injection for first procedure, which may indicate a preference for surgical intervention over injection. Future studies should evaluate the long-term efficacy and costs of these procedures based on diagnosis type.