• Laxmaiah Manchikanti, Standiford Helm Ii, Vidyasagar Pampati, and Gabor B Racz.
• Pain Management Center of Paducah, Paducah, KY, and University of Louisville, Louisville, KY; The Helm Center for Pain Management, Laguna Hills, CA; and Texas Tech University Health Sciences Center, Lubbock, TX.
• Pain Physician. 2014 Mar 1;17(2):E129-39.

BackgroundMultiple reviews have shown that interventional techniques for chronic pain have increased dramatically over the years. Of these interventional techniques, both sacroiliac joint injections and facet joint interventions showed explosive growth, followed by epidural procedures. Percutaneous adhesiolysis procedures have not been assessed for their utilization patterns separately from epidural injections.Study DesignAn analysis of the utilization patterns of percutaneous adhesiolysis procedures in managing chronic low back pain in the Medicare population from 2000 to 2011.ObjectiveTo assess the utilization and growth patterns of percutaneous adhesiolysis in managing chronic low back pain.MethodsThe study was performed utilizing the Centers for Medicare and Medicaid Services (CMS) Physician Supplier Procedure Summary Master of Fee-For-Service (FFS) Data from 2000 to 2011.ResultsPercutaneous adhesiolysis procedures increased 47% with an annual growth rate of 3.6% in the FFS Medicare population from 2000 to 2011. These growth rates are significantly lower than the growth rates for sacroiliac joint injections (331%), facet joint interventions (308%), and epidural injections (130%), but substantially lower than lumbar transforaminal injections (665%) and lumbar facet joint neurolysis (544%).LimitationsStudy limitations include lack of inclusion of Medicare Advantage patients. In addition, the statewide data is based on claims which may include the contiguous or other states.ConclusionPercutaneous adhesiolysis utilization increased moderately in Medicare beneficiaries from 2000 to 2011. Overall, there was an increase of 47% in the utilization of adhesiolysis procedures per 100,000 Medicare beneficiaries, with an annual geometric average increase of 3.6%.

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