A study presented at the Society for Minimally Invasive Spine Surgery Global Forum in 2014 examined opioid consumption in the workman's compensation patient population after minimally invasive transforaminal lumbar interbody fusion.
The researchers examined 136 patients who underwent MIS TLIF surgery from 2007 to 2013. The patients either had workman's compensation insurance or other insurance. The researchers found:
1. The patients with workman's compensation tended to be around 10 years younger than the non-workman's compensation patients undergoing MIS TLIF and had a lower comorbidity burden.
2. The payer status didn't have a significant impact on perioperative blood loss or complications.
3. The patients with workman's compensation were more likely to have longer operations — 135 minutes, compared to 119 minutes for the non-workman's compensation patients.
4. The hospital length of stay was similar between the two groups, but the workman's compensation patients were less likely to be discharged postop day one. Eight percent of the workman's compensation patients were discharged postop day one, compared with 22 percent of the non-workman's compensation patients.
5. The workman's compensation patients were more likely to have oral and intravenous opioid administration, but the cumulative opioid requirements were similar between both groups.
"Despite concerns for greater opioid abuse in the WC population, this analysis did not demonstrate significant differences in narcotic consumption between WC and non-WC patients during the immediate postoperative period," concluded the study authors. However, they did suggest the higher proportion of intravenous and oral opioid among the WC patients could be associated with the delayed discharge.