Treatment of chronic pain with spinal cord stimulation versus alternative therapies

Cost-effectiveness analysis

Krishna Kumar, Samaad Malik, Denny Demeria, Yücel Kanpolat, Kim Burchiel

Research output: Contribution to journalArticle

163 Citations (Scopus)

Abstract

OBJECTIVE: There is limited available research measuring the cost-effectiveness of spinal cord stimulation (SCS), compared with best medical treatment/conventional pain therapy (CPT). The purpose of this study was to tabulate the actual costs (in Canadian dollars) for a consecutive series of patients treated with SCS in a constant health care delivery environment and to compare the costs with those for a control group treated in the same controlled environment. METHODS: We present a consecutive series of 104 patients with failed back syndrome. Within this group, 60 patients underwent SCS electrode implantation, whereas 44 patients were designated as control subjects. We monitored these patients for a 5-year period and tabulated the actual costs incurred in diagnostic imaging, professional fees paid to physicians, implantation (including the costs for hardware), nursing visits for maintenance of the stimulators, physiotherapy, chiropractic treatments, massage therapy, and hospitalization for treatment of breakthrough pain. From these data, the cumulative costs for each group were calculated for a 5-year period. An analysis of Oswestry questionnaire results was also performed, to evaluate the effects of treatment on the quality of life. RESULTS: The actual mean cumulative cost for SCS therapy for a 5-year period was $29,123/patient, compared with $38,029 for CPT. The cost of treatment for the SCS group was greater than that for the CPT group in the first 2.5 years. The costs of treating patients with SCS became less than those for CPT after that period and remained so during the rest of the follow-up period. In addition, 15% of SCS-treated patients were able to return to employment, because of superior pain control and lower drug intake. No patients in the control group were able to return to employment of any kind. CONCLUSION: SCS is cost-effective in the long term, despite the initial high costs of the implantable devices.

Original languageEnglish (US)
Pages (from-to)106-116
Number of pages11
JournalNeurosurgery
Volume51
Issue number1
DOIs
StatePublished - Jul 1 2002
Externally publishedYes

Fingerprint

Spinal Cord Stimulation
Complementary Therapies
Chronic Pain
Cost-Benefit Analysis
Costs and Cost Analysis
Pain
Therapeutics
Breakthrough Pain
Chiropractic
Controlled Environment
Control Groups
Massage
Fees and Charges
Drug and Narcotic Control
Diagnostic Imaging
Group Psychotherapy
Health Care Costs
Electrodes
Hospitalization
Nursing

Keywords

  • Chronic pain
  • Cost-effectiveness analysis
  • Spinal cord stimulation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Treatment of chronic pain with spinal cord stimulation versus alternative therapies : Cost-effectiveness analysis. / Kumar, Krishna; Malik, Samaad; Demeria, Denny; Kanpolat, Yücel; Burchiel, Kim.

In: Neurosurgery, Vol. 51, No. 1, 01.07.2002, p. 106-116.

Research output: Contribution to journalArticle

Kumar, Krishna ; Malik, Samaad ; Demeria, Denny ; Kanpolat, Yücel ; Burchiel, Kim. / Treatment of chronic pain with spinal cord stimulation versus alternative therapies : Cost-effectiveness analysis. In: Neurosurgery. 2002 ; Vol. 51, No. 1. pp. 106-116.
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