Background & Aims
Spinal cord stimulation (SCS) entails the placement of electrodes within the epidural space to generate an electrical field selectively targeting the dorsal columns of the spinal cord. This therapeutic modality is believed to operate through a device delivering electrical pulses to the spinal cord, interrupting nerve signals before reaching the brain. While recognized as a therapy for various chronic pain conditions, real-world assessments of trial-to-permanent SCS implantation rates, SCS removal rates, and opioid prescription reductions post-implantation are lacking. Thus, we conducted an evaluation using Korean National Health Insurance Claims.
Methods
We retrospectively analyzed longitudinal claims data from the Health Insurance and Review Agency database spanning 2009 to 2020. Demographics, patient pathways, and healthcare utilization outcomes in individuals using SCS were systematically gathered.
Results
Among 1404 patients who underwent SCS trials, 912 (65.0%) proceeded to permanent SCS implantation. Of those with SCS implanted patients, 226 patients (24.7%) underwent SCS removal, on average, 1558 ± 1006 days post-implantation. Following permanent SCS implantation, 273 patients (30.2%) experienced a 50% reduction in prescribed opioids.
Conclusions
Our findings suggest that SCS is an effective treatment option for chronic pain patients, demonstrating relative tolerability post-implantation. The study provides insights into trial-to-permanent implantation rates, stimulator removal rates, and opioid prescription reductions after SCS, contributing to a better understanding of the real-world implications of this therapeutic approach.
References
1. Dhruva SS, Murillo J, Ameli O, Morin PE, Spencer DL, Redberg RF, Cohen K. Long-term Outcomes in Use of Opioids, Nonpharmacologic Pain Interventions, and Total Costs of Spinal Cord Stimulators Compared With Conventional Medical Therapy for Chronic Pain. JAMA Neurol. 2023 Jan 1;80(1):18-29.
2. Luecke T, Kuhlmann H, May M, Petermann M, Libutzki B, Jäehnichen G. Spinal cord stimulation: a real-world data analysis on outcomes and differences between rechargeable and non-rechargeable implantable pulse generators. J Int Med Res. 2021 Aug;49(8):3000605211038457.