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管理脊柱疼痛的关节突关节介入治疗的利用模式:美国按服务收费的医疗保险人群的回顾性队列研究。

Utilization Patterns of Facet Joint Interventions in Managing Spinal Pain: a Retrospective Cohort Study in the US Fee-for-Service Medicare Population.

机构信息

Pain Management Center of Paducah, 2831 Lone Oak Road, Paducah, KY, 42003, USA.

University of Louisville, Louisville, KY, USA.

出版信息

Curr Pain Headache Rep. 2019 Aug 6;23(10):73. doi: 10.1007/s11916-019-0816-7.

Abstract

PURPOSE OF REVIEW

To assess patterns of utilization and variables of facet joint interventions in managing chronic spinal pain in a fee-for-service (FFS) Medicare population from 2009 to 2016, with a comparative analysis from 2000 to 2009 and 2009 to 2016.

RECENT FINDINGS

From 2009 to 2016, facet joint interventions increased at an annual rate of 2% per 100,000 Medicare population compared to 10.2% annual rate of increase from 2000 to 2009. Lumbosacral facet joint nerve block episodes decreased at an annual rate of 0.1% from 2009 to 2016, with an increase of 16.2% from 2000 to 2009. In contrast, lumbosacral facet joint neurolysis episodes increased at an annual rate of 7.6% from 2009 to 2016 and the utilization rate also increased at an annual rate of 26% from 2000 to 2009. The ratio of lumbar facet joint block episodes to lumbosacral facet joint neurolysis episodes changed from 6.7 in 2000 to 2.2 in 2016. From 2009 to 2016, cervical and thoracic facet joint injections increased at an annual rate of 0.6% compared to cervicothoracic facet neurolysis episodes of 9.2%. During 2000 to 2009, annual increase of cervical facet joint injections was 18% compared to neurolysis procedures of 26%. The ratio of cervical facet joint injections episodes to neurolysis episodes changed from 8.85 in 2000 to 2.8 in 2016. In summary, based on available data, utilization patterns of facet joint interventions demonstrated an increase of 2% per 100,000 Medicare population from 2009 to 2016, with an annual decline of lumbar facet joint injection episodes.

摘要

目的综述

评估在 2009 至 2016 年间,按服务计费(FFS)医疗保险人群中,采用关节突关节介入治疗管理慢性脊柱疼痛的模式及相关变量,并与 2000 至 2009 年和 2009 至 2016 年的情况进行比较分析。

最近发现

与 2000 至 2009 年的 10.2%的年增长率相比,2009 至 2016 年间,关节突关节介入治疗的年增长率为每 10 万医疗保险人群增加 2%。2009 至 2016 年间,腰椎-骶骨关节突神经阻滞术的年发生率下降了 0.1%,而 2000 至 2009 年间则增加了 16.2%。相比之下,2009 至 2016 年间,腰椎-骶骨关节突神经松解术的年发生率增加了 7.6%,使用率也从 2000 至 2009 年的每年增加 26%。2000 年,腰椎关节突关节阻滞术与腰椎-骶骨关节突神经松解术的比例为 6.7,而 2016 年则降至 2.2。2009 至 2016 年间,颈椎和胸椎关节突关节注射术的年增长率为 0.6%,而颈椎-胸椎关节突神经松解术的年增长率为 9.2%。2000 至 2009 年间,颈椎关节突关节注射术的年增长率为 18%,而神经松解术的年增长率为 26%。2000 年,颈椎关节突关节注射术与神经松解术的比例为 8.85,而 2016 年则降至 2.8。总之,根据现有数据,2009 至 2016 年间,关节突关节介入治疗的使用率每年增加 2%,每 10 万医疗保险人群中,腰椎关节突关节注射术的年发生率呈下降趋势。

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