Abstract
Fibromyalgia is associated with poor outcomes in patients undergoing various orthopedic procedures. No prior study has evaluated if this cohort has worse outcomes following spine surgery.
The purpose of this study is to identify 90-day postoperative complications in patients with a history of fibromyalgia undergoing one- to two- level spine fusion.
Retrospective database review.
The Pearl Diver database (Pearl Diver Technologies, West Conshohocken, PA, USA) identified all patients undergoing one- to two- level spine from 2005 to 2014, from the Medicare provider. All patients with a history of fibromyalgia were also identified. Our consisted of two groups: patients with and without a history of fibromyalgia undergoing primary one- to two- level spine fusion.
A total of 90-day medical complications were assessed including length of stay, readmission rates, and total cost of care.
All patients in the database undergoing primary one- to two- level spine fusion were identified, in addition to all patients with a history of fibromyalgia 90days prior to their index procedure and having a diagnosis on the same day. This cohort served as our study group. Patients without a diagnosis of fibromyalgia undergoing one- to two- level spine fusion served as our control group. Patients from both cohorts were randomly matched based on age, gender, and comorbidities. Both groups were longitudinally followed for 90days to assess medical complications, readmission rates and total cost of care.
Fibromyalgia patients had a greater total odds of postoperative complications within the first 90 days (OR: 2.05, p<.001). Day of surgery cost was also higher in patients with fibromyalgia ($95,036.93vs. $94,825.06, P=.021)
Patients with fibromyalgia are at greater odds for postoperative complications 90days following surgery. Additionally, fibromyalgia patients are more likely to be readmitted to the hospital within the first 90days. Due to the complications caused by fibromyalgia, patients with this condition undergoing one- to two- level spine fusion incur a greater total cost of care on the day of the surgery and 90days after.