The Effect of Kyphoplasty on Opioid Use in Patients With Vertebral Compression Fractures

TL;DR

This study found that kyphoplasty may reduce opioid use and pain in patients with vertebral compression fractures.

Contribution

The study provides evidence that kyphoplasty is associated with decreased opioid consumption and pain scores in eligible patients.

Findings

Kyphoplasty was linked to a significant reduction in prescribed opioid doses and total morphine milliequivalents.

Pain scores decreased significantly in both opioid and non-opioid groups after kyphoplasty.

The study highlights the need for larger trials comparing kyphoplasty to conservative management.

Abstract

Objective

The primary objective of this study was to assess opioid use in the 90 days following kyphoplasty (KP) compared to the period between compression fracture and KP.

Methods

All patients aged 50-85 who underwent KP following a newly diagnosed vertebral compression fracture (VCF) at a large, urban academic medical center between January 1st, 2015, and January 1st, 2023, were screened for inclusion. Patients were excluded if they had an opioid prescription in the month prior to the compression fracture, had a history of malignancy, or underwent concomitant or other surgical procedures in the 90 days following KP. Opioid measures, including the prescribed amount of morphine milliequivalents (MME) per day, number of opioid days, and total MME (MME per day x number of opioid days), in addition to numerical rating scale (NRS) pain scores, were analyzed pre- and post-KP.

Results

A total of 27 patients met the eligibility criteria, with a mean age of 69.7 and 59.2% being female. Sixteen patients (59%) had received an opioid prescription between compression fracture and KP (opioid group). The median differences pre- and post-KP in prescribed MMEs per day, number of opioid days, and total MMEs were 17.7 (p=.0009), 11.0 (p=.0004), and 232.5 (p<.0001), respectively. There was a significant difference in NRS pain scores in both the opioid group (6.25, p<.0001) and the non-opioid group (4.36, p<.0001) pre- and post-KP.

Conclusion

Our findings suggest that KP may be associated with a reduction in both opioid use and pain scores in opioid-naïve patients with VCFs. Larger studies that directly compare KP to conservative management are needed to fully assess the impact of KP on opioid and pain outcome measures.

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