LAUSR

OBJECTIVE To quantify and compare utilization of opioids, exercise therapy and physical therapy in the year before spine surgery. DESIGN A retrospective cohort of surgical and claims data SETTING: Beneficiaries of the Military Health System seen at Brooke Army Medical Center PARTICIPANTS: 411 patients undergoing surgery between 1 January 2014 and 31 December 2015, identified retrospectively through the Surgical Scheduling System (S3) based on procedure type (fusion, laminectomy, arthroplasty, vertebroplasty, and discectomy). INTERVENTIONS Elective lumbar spine surgery MAIN OUTCOMES: Healthcare utilization variables present during the full 12 months prior to surgery, that included physical therapy services and visits for exercise therapy or manual therapy procedures and opioid prescriptions. RESULTS The mean age of participants was 44.8 (SD 11.7) years and 32.4% were female. In the year prior to surgery, 143 (34.8%) had a physical therapy plan of care, 140 (34.1%) had at least one visit that included exercise therapy, and only 60 (14.6%) had a minimum of 6 exercise therapy visits. However, 347 (84.4%) received at least one opioid prescription fill (mean of 6.1 unique fills). CONCLUSION Prior to elective lumbar spine surgery, opioid prescriptions were common but physical therapy services and exercise therapy utilization occurred infrequently.