976 - Opioid prescription patterns in SI Joint Fusion Patients: A Retrospective Cohort Study

Sacroiliac (SI) joint dysfunction is a common cause of chronic low back pain, impacting 15-25% of the patients in this population. There are numerous conservative treatment options, but in those with refractory chronic SI dysfunction, SI joint fusion surgery is an option. However, there is limited information about opioid use pre and post operatively in this patient population. The goal of this study is to evaluate the rate of opioid use and SI joint injections in patients before and after SI joint fusion.

Design:

TriNetX, a national network of de-identified patient records, was retrospectively queried with ICD-10, VA, and CPT codes. Propensity-score matching (PSM) analysis was done based on demographics and comorbidities.

Results:

4,639 total patients were included in our cohort. 3,605 patients had received opioids prior to SI joint fusion surgery, while 1,034 patients did not receive any opioids prior to surgery. After PSM, patients with opioid use prior to SI joint fusion were significantly more likely to be prescribed opioids, undergo physical therapy, undergo a future spine surgery, or receive an SI joint injection 2 years post-operatively compared to the patients not taking opioids. Opioid prescriptions, physical therapy sessions, and future spine surgeries were also significantly higher in the opioid group compared to the non-opioid group at 12 months post-operatively.

Conclusions:

Patients managed with opioids prior to SI joint fusion were more likely to be prescribed opioids following the fusion. Additionally, those on opioids prior to SI joint fusion were more likely to utilize physical therapy, undergo a future spine surgery, or have SI joint injections compared to patients not on opioids prior to their SI joint fusion at the 2 year mark.