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Effectiveness of cervical spinal cord stimulation for the management of chronic pain.
Neuromodulation. 2014 Apr; 17(3):265-71; discussion 271.N

Abstract

INTRODUCTION

Scientific evidence supports spinal cord stimulation (SCS) as a cost-effective treatment option that, for many disease states, should be employed earlier in the treatment continuum. Reimbursement for SCS in the cervical spine has recently been challenged based on supposed lack of clinical literature. To refute this assumption, we analyzed data from an international registry to support the use of cervical SCS.

MATERIALS AND METHODS

The following outcomes were collected as part of an institutional review board-approved, prospective, multicenter, international registry: pain relief, Pain Disability Index (PDI) score, quality of life (QoL), and satisfaction at 3, 6, and 12 months post-implantation. Descriptive statistics are provided for all measures. Changes from baseline in PDI scores were analyzed using Tukey's pairwise comparisons.

RESULTS

Thirty-eight patients underwent implantation of SCS leads in the cervical spine at 16 study sites in the United States and 3 international study sites. Direct patient report of percentage of pain relief was 54.2%, 60.2%, and 66.8% at 3, 6, and 12 months post-implantation, respectively. Pain relief was categorized as excellent/good by 61.6% of patients at 3 months, with similar results observed at 6 and 12 months. PDI scores were significantly reduced at all time points. At 3 months post-implantation, 92.4% of patients indicated they were very satisfied/satisfied with the SCS device. No patients indicated that they were dissatisfied. Overall QoL was reported as improved/greatly improved by 73.1% of patients at 3 months. Similar results for QoL and satisfaction were reported at 6 and 12 months.

CONCLUSION

The results suggest that the use of SCS in the cervical spine is a medically effective method of pain management that satisfies and improves the QoL of most patients. The use of SCS can reduce the high cost of direct medical treatment of pain, as well as increasing the productivity of patients, and therefore should be reimbursed in appropriately selected patients.

Authors+Show Affiliations

The Center for Pain Relief, Charleston, WV, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Review

Language

eng

PubMed ID

24112709

Citation

Deer, Timothy R., et al. "Effectiveness of Cervical Spinal Cord Stimulation for the Management of Chronic Pain." Neuromodulation : Journal of the International Neuromodulation Society, vol. 17, no. 3, 2014, pp. 265-71; discussion 271.
Deer TR, Skaribas IM, Haider N, et al. Effectiveness of cervical spinal cord stimulation for the management of chronic pain. Neuromodulation. 2014;17(3):265-71; discussion 271.
Deer, T. R., Skaribas, I. M., Haider, N., Salmon, J., Kim, C., Nelson, C., Tracy, J., Espinet, A., Lininger, T. E., Tiso, R., Archacki, M. A., & Washburn, S. N. (2014). Effectiveness of cervical spinal cord stimulation for the management of chronic pain. Neuromodulation : Journal of the International Neuromodulation Society, 17(3), 265-71; discussion 271. https://doi.org/10.1111/ner.12119
Deer TR, et al. Effectiveness of Cervical Spinal Cord Stimulation for the Management of Chronic Pain. Neuromodulation. 2014;17(3):265-71; discussion 271. PubMed PMID: 24112709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of cervical spinal cord stimulation for the management of chronic pain. AU - Deer,Timothy R, AU - Skaribas,Ioannis M, AU - Haider,Nameer, AU - Salmon,John, AU - Kim,Chong, AU - Nelson,Christopher, AU - Tracy,Jerry, AU - Espinet,Anthony, AU - Lininger,Todd E, AU - Tiso,Robert, AU - Archacki,Melinda A, AU - Washburn,Stephanie N, Y1 - 2013/09/24/ PY - 2013/05/23/received PY - 2013/07/15/revised PY - 2013/08/06/accepted PY - 2013/10/12/entrez PY - 2013/10/12/pubmed PY - 2014/12/15/medline KW - Cervical radiculopathy KW - cervical spinal cord stimulation KW - complex regional pain syndrome KW - failed neck surgery syndrome KW - registry SP - 265-71; discussion 271 JF - Neuromodulation : journal of the International Neuromodulation Society JO - Neuromodulation VL - 17 IS - 3 N2 - INTRODUCTION: Scientific evidence supports spinal cord stimulation (SCS) as a cost-effective treatment option that, for many disease states, should be employed earlier in the treatment continuum. Reimbursement for SCS in the cervical spine has recently been challenged based on supposed lack of clinical literature. To refute this assumption, we analyzed data from an international registry to support the use of cervical SCS. MATERIALS AND METHODS: The following outcomes were collected as part of an institutional review board-approved, prospective, multicenter, international registry: pain relief, Pain Disability Index (PDI) score, quality of life (QoL), and satisfaction at 3, 6, and 12 months post-implantation. Descriptive statistics are provided for all measures. Changes from baseline in PDI scores were analyzed using Tukey's pairwise comparisons. RESULTS: Thirty-eight patients underwent implantation of SCS leads in the cervical spine at 16 study sites in the United States and 3 international study sites. Direct patient report of percentage of pain relief was 54.2%, 60.2%, and 66.8% at 3, 6, and 12 months post-implantation, respectively. Pain relief was categorized as excellent/good by 61.6% of patients at 3 months, with similar results observed at 6 and 12 months. PDI scores were significantly reduced at all time points. At 3 months post-implantation, 92.4% of patients indicated they were very satisfied/satisfied with the SCS device. No patients indicated that they were dissatisfied. Overall QoL was reported as improved/greatly improved by 73.1% of patients at 3 months. Similar results for QoL and satisfaction were reported at 6 and 12 months. CONCLUSION: The results suggest that the use of SCS in the cervical spine is a medically effective method of pain management that satisfies and improves the QoL of most patients. The use of SCS can reduce the high cost of direct medical treatment of pain, as well as increasing the productivity of patients, and therefore should be reimbursed in appropriately selected patients. SN - 1525-1403 UR - https://www.unboundmedicine.com/medline/citation/24112709/Effectiveness_of_cervical_spinal_cord_stimulation_for_the_management_of_chronic_pain_ L2 - https://doi.org/10.1111/ner.12119 DB - PRIME DP - Unbound Medicine ER -