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.