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A rule that discourages surgery and opioid use in favor of conservative therapy for workers with lower back injuries was approved by the Ohio Bureau of Workers’ Compensation Wednesday.
The new rule requires that workers undergo at least 60 days of comprehensive conservative care — including physical therapy, chiropractic care, rest, anti-inflammatories, ice and other nonsurgical remedies — before surgical options are considered. Conditions that require immediate intervention, such as spinal fractures, tumors, infections and functional neurological deficits, are exceptions to the rule, BWC said in a statement.
BWC Chief Medical Officer Dr. Stephen T. Woods, researchers at Case Western University School of Medicine and others found that “fusion patients suffered considerably worse outcomes than non-fusion patients. Those outcomes included chronic opioid dependence, increased disability and high rates of failed back syndrome, as well as additional surgery and new psychiatric co-morbidities,” according to the statement.
Lower back injuries are among the top injury types for Ohio workers even though the number of lumbar fusion procedures performed on Ohio workers comp claimants dropped from 1,375 in 2002 to 563 in 2015, according to the statement.
“Our mission is to get injured workers back to work and back to life as soon as safely possible, and our research shows that rushing to surgery may not be the best path for workers with lower back injuries,” said bureau administrator and CEO Sarah Morrison in the statement.
The number of inpatient hospitalizations among injured workers in California has declined, in part because of a reduction in the number of implant-eligible spinal surgeries in recent years, according the California Workers' Compensation Institute.