• Laxmaiah Manchikanti, Vidyasagar Pampati, Frank J E Falco, and Joshua A Hirsch.
• Pain Management Center of Paducah, 2831 Lone Oak Rd, Paducah, KY 42003, USA. drlm@thepainmd.com
• Spine. 2013 Jan 15; 38 (2): 157-68.

Study DesignAnalysis of the growth, utilization trends, and Medicare expenditures of spinal interventional pain management techniques from 2000 through 2008.ObjectiveTo evaluate the use of epidural steroid injections, facet joint interventions, and sacroiliac joint interventions, and to analyze the trends of Medicare utilization and expenditures in multiple settings-namely, hospital outpatient departments, ambulatory surgery centers, and physician offices.Summary Of Background DataThere has been an explosive growth of many invasive and noninvasive modalities designed to manage chronic spinal pain. Commonly used interventional techniques include epidural steroid injections, facet joint interventions, and sacroiliac joint interventions. However, their effectiveness and the appropriateness of their application continue to be debated.MethodsThe present article provides an analysis of the growth of spinal interventional techniques, as described earlier, for managing the chronic spinal pain of Medicare beneficiaries from 2000 through 2008. The standard 5% national sample of the Centers for Medicare and Medicaid Services carrier claims that record data from 2000 through 2008 were utilized. Current procedural terminology codes from 2000 through 2008 were used to identify the number of procedures performed each year, as well as trends and expenditures.ResultsMedicare recipients receiving spinal interventional techniques increased 107.8% from 2000 through 2008, with an annual average increase of 9.6%, whereas spinal interventional techniques increased 186.8%, an annual average increase of 14.1% per 100,000 beneficiaries.ConclusionThe study suggests explosive increases in spinal interventional techniques from 2000 to 2008, with some slowing of growth in later years.

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