Chronic low back pain: reduced opioid use linked to improved outcomes

  • Markman JD & al.
  • Neurosurgery
  • 29 Apr 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Patients with chronic low back pain (CLBP) who reported decreased opioid use had greater improvement in pain intensity and functional outcomes following basivertebral nerve (BVN) radiofrequency ablation (RA) compared with those who reported increased opioid use.

Why this matters

  • Findings suggest that in CLBP patients with baseline short-acting opioid use, the pain relief obtained following BVN ablation may enable dose reduction .

Study design

  • This post hoc analysis of randomised, sham-controlled, double-blind trial compared the short-acting opioid use between treatment arm (BNV RA) and sham arm from baseline through 1 year.
  • Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) measurements were compared between patients with increased and decreased opioid usage vs baseline in both arms.
  • Funding: Relievant Medsystems.

Key results

  • In treatment arm, patients with decreased opioid use (n=27) at 1 year vs those with increased opioid use (n=18) had significant improvement in:
    • mean ODI (24.9 ± 16.0 vs 7.3 ± 9.8)
    • VAS (3.3 ± 2.5 vs 0.6 ± 1.8; P<.001 for both>
  • In the sham arm, patients with decreased opioid use (n=19) vs those with increased opioid use (n=5) did not differ in:
    • mean ODI (17.4 ± 16.1 vs 1.2 ± 14.3; P=.053).
    • VAS (2.5 ± 2.6 vs 1.4 ± 1.9; P=.374).

Limitations

  • Post hoc analysis.
  • Opioid use was monitored using self-reported patient questionnaires.

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