Patients with fibromyalgia who undergo spinal fusion surgery are more likely to experience complications such as postoperative bleeding and pneumonia, along with higher costs of care and higher readmission rates, according to researchers.
Their study, “Fibromyalgia as a Predictor of Increased Post-Operative Complications, Readmission Rates and Hospital Costs in Patients Undergoing Posterior Lumbar Spine Fusion,” was published in the journal Spine.
Fibromyalgia is a chronic condition characterized by an impairment in central pain processing that likely develops due to a number of factors.
Patients with fibromyalgia are at increased risk for developing degenerative disc diseases (DDD) due to higher levels of joint hypermobility (where joints easily move beyond the normal expected range), leading to tearing of muscle fibers in the spinal disc spaces.
Other factors, such as high rates of osteoporosis (bone loss), low vitamin D levels (which help maintain bone balance), and a more sedentary lifestyle, can also contribute to fibromyalgia patients having an increased risk of developing DDD.
Patients with fibromyalgia may eventually need a spinal fusion, a surgical procedure used to correct problems in the small bones in the spine — essentially a welding process.
Fibromyalgia patients are known to have more complications associated with surgeries compared to the general population. But there are currently no studies that have compared complications associated with spinal fusion surgery in patients with and without fibromyalgia.
Researchers looked through Medicare data from 2005 to 2014 for fibromyalgia patients who underwent spinal fusion and compared them to non-fibromyalgia patients who underwent the same surgery and had similar demographics, treatment methods, and comorbidities (the simultaneous presence of more than one chronic condition).
Specifically, researchers looked for 30-day and 90-day post-operative complication rates, readmission rates, and treatment costs.
Results showed that, within the first 30 days after the operation, patients with fibromyalgia were 2.58 times more likely to develop acute post-hemorrhagic anemia (blood loss) compared to those without fibromyalgia (controls).
And, within the first 90 days after surgery, patients with fibromyalgia were 3.73 times more likely to develop pneumonia.
Readmission rates within the first 30 days were significantly higher in fibromyalgia patients compared to controls. As a result, those with fibromyalgia experienced 5.31% more in-hospital charges compared to the control group at 90-days post-operation.
But there appeared to be no significant differences in length of stay or wound-related complications within the first 30 days between the two groups.
The authors concluded that spinal lumbar fusions “performed on fibromyalgia patients have higher rates of post-operative anemia, pneumonia, cost of care, and readmission compared to match controls.”
The authors also emphasized that fibromyalgia patients and surgeons should be aware of these increased risks in an effort to control both hospital costs and potential complications.