Photo Credit: Nathan Devery

The following is a summary of “Characterizing utilization patterns and reoperation risk factors of interspinous process devices: analysis of a national claims database,” published in the December 2023 issue of Pain by Tan et al.

Researchers conducted a retrospective study using a national claims database to analyze national trends in the use of interspinous process devices (IPDs) and patient outcomes following implantation.

They utilized the PearlDiver database to identify all patients who received 1—or 2-level IPD (2010 to 2018). Univariate and multivariable logistic regression were conducted to pinpoint predictors of the number of IPD levels implanted and reoperation within 3 years post-surgery. Kaplan-Meier curves were generated censoring right to illustrate reoperation-free survival duration, and log-rank tests were conducted for comparison.

The results showed 4,865 patients received 1-level (n = 3246) or 2-level (n = 1619) IPDs. Older age (aOR 1.02, 95% CI 1.01–1.03, P<.001), male gender (aOR 1.31, 95% CI 116–1.50, P<.001), and obesity (aOR 1.19, 95% CI 1.05–1.36, P<.01) were significantly associated with receiving a 2-level IPD. The 3-year reoperation rate was 9.3% of patients when accounting for mortality. Older age decreased the likelihood of reoperation (aOR 0.97, 95% CI 0.97–0.99, P=.0039), while 1-level IPD (aOR 1.37, 95% CI 1.01–1.89, P=.048), Charlson Comorbidity Index (aOR 1.07, 95% CI 1.01–1.14, P=.018), and concomitant open decompression increased it (aOR 1.68, 95% CI 1.35–2.09, P=.0014).

They concluded that higher rates of 2-level IPDs in older males with obesity. Open decompression with IPDs increased reoperation risk.

Source: academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnad159/7462775