Back to Search
Start Over
A Systematic Review of the Cost-Utility of Spinal Cord Stimulation for Persistent Low Back Pain in Patients With Failed Back Surgery Syndrome
- Source :
- Global Spine Journal
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Study Design: Systematic Review. Objectives: To review the literature surrounding the cost-effectiveness of implanting spinal cord stimulators for failed back surgery syndrome. Methods: A systematic review was conducted inclusive of all publications in the Medline database and Cochrane CENTRAL trials register within the last 10 years (English language only) assessing the cost-effectiveness of Spinal Cord Stimulator device implantation (SCSdi) in patients with previous lumbar fusion surgery. Results: The majority of reviewed publications that analyzed cost-effectiveness of SCSdi compared to conventional medical management (CMM) or re-operation in patients with failed back surgery syndrome (FBSS) showed an overall increase in direct medical costs; these increased costs were found in nearly all cases to be offset by significant improvements in patient quality of life. The cost required to achieve these increases in quality adjusted life years (QALY) falls well below $25 000/QALY, a conservative estimate of willingness to pay. Conclusions: The data suggest that SCSdi provides both superior outcomes and a lower incremental cost: effectiveness ratio (ICER) compared to CMM and/or re-operation in patients with FBSS. These findings are in spite of the fact that the majority of studies reviewed were agnostic to the type of device or innervation utilized in SCSdi. Newer devices utilizing burst or higher frequency stimulation have demonstrated their superiority over traditional SCSdi via randomized clinical trials and may provide lower ICERs.
- Subjects :
- Special Issue Articles
medicine.medical_specialty
cost benefit
Cost effectiveness
law.invention
03 medical and health sciences
spinal cord stimulator
0302 clinical medicine
Lumbar
Randomized controlled trial
Quality of life
law
lumbar interbody fusion
medicine
cost utility
Orthopedics and Sports Medicine
030212 general & internal medicine
health care economics and organizations
electric stimulation therapy
cost effectiveness
quality adjusted life years
business.industry
spinal cord
Spinal cord
Low back pain
Spinal cord stimulator
Quality-adjusted life year
medicine.anatomical_structure
quality of life
Physical therapy
Surgery
failed back surgery syndrome
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 21925690 and 21925682
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Global Spine Journal
- Accession number :
- edsair.doi.dedup.....77c26f3cb2c7ba101a4bdaf041ac3397