Physicians and researchers recently published an article in Spine about the use of spinal cord stimulation in patients with failed back surgery syndrome.
The researchers examined MarketScan data to analyze patients with FBSS who underwent spinal cord stimulation or spinal reoperation from 2000 to 2009. There were 16,455 patients included in the study, with only 395 undergoing SCS implantation. The researchers found:
1. Complication rate was significantly lower at 90 days among the patients who received SCS than spinal reoperation. However, this is hardly the first study to show such results. "Although previous studies have demonstrated superior efficacy for the treatment of FBSS, SCS remains underused," the study authors wrote in the conclusion. "Despite no significant decreases in overall healthcare cost with SCS implantation, because it is associated with decreased complications and improved outcomes, this technology warrants closer consideration for the management of chronic pain in patients with FBSS."
2. Hospital stay was shorter among patients with SCS implantation. The neurostimulation market is one of the fastest growing in medical technology, according to the QiG group. The market was at less than 10 percent penetration in 2012 — reaching $2.575 billion as an entire segment with $1.4 billion attributed to SCS — but QiG group projected the total segment would reach $4.51 billion by 2016; SCS would reach $2.3 billion.
3. Associated hospital costs as well as overall cost were lower among the SCS group than the reoperation group. The overall cost for the lumbar reoperation group was $82,586, compared with the SCS group that reported a total cost of $80,669. According to a Cost Helper Health report, the typical out-of-pocket costs for the spinal cord stimulator among uninsured patients range from $15,000 to $50,000.
The Journal of Neurosurgery: Spine published an article estimating the cost per patient of spinal cord stimulator implantation at $32,882 for Medicare patients and $57,896 for Blue Cross Blue Shield, with annual maintenance reaching $5,071 to $21,390.
4. Outpatient, emergency room visits and medication changes were similar among both groups of patients. FBSS has major consequences for patients and can be a source of chronic neuropathic pain; it impacts up to 40 percent of patients who undergo lumbosacral spine surgery for back pain, according to the study.
5. A 2011 study published in Spine examined the cost-effectiveness for spinal cord stimulation for failed back surgery syndrome among workers compensation patients. The researchers found that among their patient population, SCS was not cost-effective. The average medical cost for SCS patients during a 24 month period was $52,091, compared to the patients treated at a pain clinic for $28,128 on average. The average total medical and productivity loss costs per patient in the SCS group were around $20,000 higher than those who visited the pain clinic; the SCS group medical and productivity loss costs per patient were around $29,000 higher than patients who received "usual care."
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