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. 2023 Apr;12(2):505-527.
doi: 10.1007/s40122-023-00476-3. Epub 2023 Feb 1.

Impact of the COVID-19 Pandemic on Utilization Patterns of Facet Joint Interventions in Managing Spinal Pain in a Medicare Population

Laxmaiah Manchikanti  1   2   3 , Alan D Kaye  4 , Richard E Latchaw  5 , Mahendra R Sanapati  6 , Vidyasagar Pampati  7 , Christopher G Gharibo  8   9 , Sheri L Albers  10 , Joshua A Hirsch  11
Affiliations

Impact of the COVID-19 Pandemic on Utilization Patterns of Facet Joint Interventions in Managing Spinal Pain in a Medicare Population

Laxmaiah Manchikanti et al. Pain Ther. 2023 Apr.

Abstract

Introduction: The COVID-19 pandemic resulted in major disruptions in all aspects of human life including a decline of medical services utilized during 2020. An analysis of the impact of COVID-19 pandemic showed an 18.7% reduction in utilization patterns of interventional techniques in managing chronic pain in the Medicare population from 2019 to 2020. However, specific changes in utilization patterns of facet joint interventions have not been studied. Thus, we sought to assess the utilization patterns including an update of facet joint interventions from 2018 to 2020, with analysis of the impact of COVID-19 pandemic in managing chronic spinal pain utilizing facet joint interventions in the fee-for-service Medicare population of the United States.

Methods: The present investigation was designed to assess utilization patterns and variables of facet joint interventions, in managing chronic spinal pain from 2010 to 2020 in the fee-for-service (FFS) Medicare population in the United States (US), and how the COVID-19 pandemic impacted these utilization patterns. Data for the analysis were obtained from the master database from the Centers for Medicare & Medicaid Services (CMS) physician/supplier procedure summary from 2000 to 2020.

Results: Results of this analysis showed significant impact of COVID-19 with overall decrease of 18.5% of all facet joint interventions per 100,000 Medicare population compared to 20.2 and 20.5% decrease for lumbar and cervical facet joint injections, 15 and 13.1% decrease per 100,000 Medicare population of lumbosacral and cervicothoracic facet joint neurolysis procedures. The results are significant in that comparative analysis from 2000 to 2010 and 2010 to 2019 showing an annual increase of 14.4 vs. 2.2%, illustrating a decelerating pattern. There were also significant growth patterns noted with decreases in facet joint injections and nerve blocks compared to facet joint neurolytic procedures.

Conclusions: This analysis shows a significant effect of COVID-19 producing an overall decrease in utilization of facet joint interventions relative to pre-COVID data. Further, the analysis demonstrates continued deceleration of utilization patterns of facet joint interventions compared to the periods of 2000-2010 and 2010-2019.

Keywords: Facet joint interventions; Facet joint nerve blocks; Facet joint neurolysis; Interventional techniques.

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Figures

Fig. 1
Fig. 1
Analysis of the annual growth the utilization rate of facet joint services in the Medicare beneficiaries, and the rate of episodes per 100,000 Medicare beneficiaries (data presented in Table 1)
Fig. 2
Fig. 2
Annual change in frequency of utilization of facet joint interventional services from 2000 to 2020 per 100,000 Medicare recipients. Data derived from Table 2
Fig. 3
Fig. 3
Annual change in frequency of utilization of facet joint interventions episodes (primary codes only) from 2000 to 2020, in Medicare recipients
Fig. 4
Fig. 4
Frequency of facet joint interventions rates by specialty groups from 2000 to 2020, in Medicare recipients
See this image and copyright information in PMC

References

    1. Jha S, Shah S, Calderon MD, Soin A, Manchikanti L. The effect of COVID-19 on interventional pain management practices: a physician burnout survey. Pain Physician. 2020;23(4S):S271–S282. - PubMed
    1. Manchikanti L, Pampati V, Jha SS, et al. The impact of COVID-19 on interventional pain management practices is significant and long-lasting: an interventional pain management physician survey. Pain Physician. 2022;25(2):131–144. - PubMed
    1. Manchikanti L, Pampati V, Sanapati MR, et al. COVID-19 pandemic reduced utilization of interventional techniques 18.7% in Managing chronic pain in the Medicare population in 2020: Analysis of utilization data from 2000 to 2020. Pain Physician. 2022;25(3):223–238. - PubMed
    1. Manchikanti L, Singh VM, Staats PS, et al. Fourth wave of opioid (illicit drug) overdose deaths and diminishing access to prescription opioids and interventional techniques: cause and effect. Pain Physician. 2022;25(2):97–124. - PubMed
    1. Manchikanti L, Vanaparthy R, Atluri S, Sachdeva H, Kaye AD, Hirsch JA. COVID-19 and the opioid epidemic: two public health emergencies that intersect with chronic pain. Pain Ther. 2021;10(1):269–286. doi: 10.1007/s40122-021-00243-2. - DOI - PMC - PubMed