Increases in lumbosacral injections in the Medicare population: 1994 to 2001.

摘要: Study design Anecdotal reports and limited data suggest that the use of spinal injections is increasing, despite equivocal evidence about efficacy. Objective We sought to evaluate trends in lumbosacral injection for low back pain, including specialties providing costs care. Summary background The current literature success rates 18% 90% steroid injections, depending on methodology, outcome measures, patient selection, technique. Preliminary are rising, ambiguity regarding their clinical effectiveness. Methods used Medicare Physician Part B claims 1994 through 2001 examine epidural (ESI), facet joint sacroiliac related fluoroscopy. Fee-for-service enrollees 65 years age older were included this study. Current Procedural Technology (CPT) codes identify number procedures performed each year, as well expenditures, physician involved, diagnoses assigned. Results Between 2001, there was a 271% increase lumbar ESIs, from 553 100,000 2055 patients, 231% 80 264 patients. total inflation-adjusted reimbursed (professional fees only) increased $24 million over $175 million. Also, per doubled, $115 $227 injection. Forty percent all ESIs associated with diagnosis sciatica, radiculopathy, or herniated disc, whereas axial pain accounted 36%, stenosis 23%. Conclusion Lumbosacral dramatically population 2001. Less than half sciatica where greatest benefit available. These findings lack consensus indications cause concern given large expenditures these procedures.