RT Journal Article
SR Electronic
T1 Gender Disparities in Outpatient Management of Postlaminectomy Syndrome
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 373
OP 377
DO 10.14444/8225
VO 16
IS 2
A1 Zhu, Amy
A1 Chiu, Ryan G.
A1 Nunna, Ravi S.
A1 Zhao, Jeffrey W.
A1 Hossa, Jessica
A1 Behbahani, Mandana
A1 Mehta, Ankit I.
YR 2022
UL https://www.ijssurgery.com/content/16/2/373.abstract
AB Introduction Postlaminectomy syndrome (PLS), also known as failed back surgery syndrome, is the persistence of radicular pain in the face of surgical intervention. Despite its prevalence in 10 to 40% of spine surgery patients, outpatient pharmacologic and interventional management remains poorly characterized.Methods The 2007 to 2016 National Ambulatory Medical Care Survey (NAMCS) was utilized to include all outpatients diagnosed with PLS. For each visit, documented pain medications (opioids, nonsteroidal anti-inflammatory drugs [NSAIDs], neuropathic agents, etc) as well as patient demographics and comorbidities (sex, age, race, insurance coverage, and medical history) were recorded. The association between medication class and rate of prescription relative to sex was assessed in the population-weighted cohort, using propensity score matching to control for potential confounders.Results A total of 70,343 PLS patients were identified, including 36,313 (51.6%) women. After accounting for baseline demographics and comorbidity differences between male and female patients, men were 2 to 3 times more likely to be prescribed opioids (OR: 2.38; 95%CI: 2.30–2.46) and procedural interventions for PLS compared to the female cohort, while women utilized neuropathic agents (OR: 0.53; 95%CI: 0.51–0.55) and NSAIDs (OR: 0.68; 95%CI: 0.65–0.70) more frequently.Conclusion Pain management in outpatients presenting with PLS-related pain consisted of higher opioid utilization for men and higher neuropathic agents and NSAIDs utilization for the female patients.Clinical Relevance This article is the first to shed light on disparities in pain management among patients with post-laminectomy syndrome.Level of Evidence 3.