Risk of Degenerative Spine Disease, Interventional Spine Procedures and Spine Surgery in Patients with Multiple Sclerosis

OBJECTIVES: To determine the association between Multiple Sclerosis (MS) and Degenerative Spine Disease (DSD) and the subsequent utilization of interventional pain (IVP) procedures and spine surgery. DESIGN: A retrospective, active comparator cohort study using TriNetX. Adults with MS were matched to adults with migraine without aura. The primary outcome was the incidence of newly recorded composite DSD within a 5-year analysis window. Utilization of spine surgery and IVP procedures was assessed over a 1-year period in separately matched cohorts indexed at the time of incident DSD. RESULTS: Among 288,401 matched patients per cohort, composite DSD occurred in 12.7% of patients with MS and 9.3% of comparators (risk ratio, 1.36). Cervical/thoracic DSD diagnoses were more frequent in MS, while lumbar cases were slightly less common. Spine surgery rates were lower in MS (1.9% vs. 2.4%; risk ratio, 0.82), as were interventional pain procedures (3.2% vs. 5.1%; risk ratio, 0.63). CONCLUSIONS: MS was associated with more frequent recorded DSD, with variation by anatomic region. IVP procedures were recorded less often among patients with MS, whereas evidence for lower overall spine surgery utilization varied across analyses.