# Nonpharmacologic Pain Management for Lumbar Surgery

> **NIH NIH UH3** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $247,617

## Abstract

PROJECT SUMMARY
This Competitive Revision proposal outlines a 1-year planning phase and 2-year clinical trial comparing
different pain management pathways to improve clinical outcomes and reduce risk for long-term opioid use for
patients following lumbar surgery. Currently, clinical outcomes following spine surgery are variable. One factor
that detracts from clinical outcomes is opioid use. Most patients considering spine surgery have experience
many years of back pain and rates of pre-surgical opioid use are high. Despite optimism that surgery will
eliminate the need for opioids, most pre-surgical opioid users persist in long-term use after the procedure. There
is also risk that patients who were not long-term users before surgery will become long-term users after surgery.
Pre-surgical opioid use is predictive of worse functional outcomes, higher complication rates and greater costs
after surgery. The premise of our project is that surgical outcomes can be improved and risk for post-surgery
opioid use reduced through comprehensive, enriched pain management designed to enhance patients' ability
and confidence in self-managing pain. Our Competitive Revision expands the scope of an ongoing clinical trial
investigating similar interventions for patients pursuing non-surgical management for chronic back pain. The
ongoing trial and this Competitive Revision are conducted in the Military Health System and investigate
pragmatic, scalable strategies that can impact practice in both Military and civilian health systems.
Following a planning year, our clinical trial will examine enriched pain management, which provides bio-
psychosocially-informed, non-pharmacologic pain treatments threaded through the pre- and post-operative
periods, tailored to individual patients and the intensity of their surgical procedure and designed to improve
clinical outcomes, enhance patients' pain self-management skills and reduce risk for long-term opioid use post-
surgery. We will compare the effectiveness of an enriched pain management pathway to a standard pathway.
Our enriched pathway uses nonpharmacologic interventions grounded in a strong scientific premise to improve
function and promote self-efficacy in non-opioid pain management. We will compare our treatment strategies in
the overall cohort and explore in sub-groups of patients based on pre-operative long-term opioid use because we
hypothesize that efficacious interventions may requiring tailoring to this particular factor. We will also explore
the mechanisms of action of our pain management pathways through mediation analysis. We will also collect
preliminary implementation metrics to inform future clinical studies and implementation efforts.
Following the planning year we expect our clinical trial to have three specific aims.
1. Compare the effectiveness of two pain management pathways (standard vs. enriched) for patients undergoing
 lumbar spine surgery in the MHS. Effectiveness will be based on post-surgery patie...

## Key facts

- **NIH application ID:** 10127813
- **Project number:** 3UH3AT009763-04S1
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Julie M Fritz
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $247,617
- **Award type:** 3
- **Project period:** 2017-09-20 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10127813

## Citation

> US National Institutes of Health, RePORTER application 10127813, Nonpharmacologic Pain Management for Lumbar Surgery (3UH3AT009763-04S1). Retrieved via AI Analytics 2026-06-02 from https://api.ai-analytics.org/grant/nih/10127813. Licensed CC0.

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