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  • Spinal Cord Stimulation: Explantation and Impact on Healthcare Cost in a Retrospective Analysis

    Final Number:
    1252

    Authors:
    Terence Verla; Gustavo Chagoya BS; Andrew Hall Marky MD; Steven M. Thomas; Shivanand P. Lad MD PhD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2014 Annual Meeting

    Introduction: Spinal Cord Stimulation (SCS) is an effective therapeutic modality providing significant benefit for many patients with chronic pain syndromes. Unfortunately, patients with SCS implants may require device explantation for various reasons, including infection, device related complications, need for imaging (MRI) or loss of efficacy over time. The purpose of this study was to attempt to evaluate the leading causes of explantation following SCS implantation surgery.

    Methods: We designed a retrospective cohort analysis using the Thompson Reuter’s MarketScan database. Patients selected were 18 and older who had a permanent spinal cord stimulator implant between 2000 and 2009. Patients with explanted SCS systems were evaluated. Possible causes of explantation such as infection, device-related complication, lumbar pathology, pain, or need for MRI were analyzed. The impact of explantation on healthcare resource utilization was also evaluated.

    Results: A total of 2456 patients underwent SCS explantation. Overall, the mean±SD age of patients with SCS explants was 52.7±13.02 years. The most common causes of explantation were infection (20.24%) and device related complication (18.43%). The annual healthcare cost was significantly higher in the explanted cohort ($47,613.6) compared to the non-explant cohort ($24,023.9).

    Conclusions: In this large, retrospective analysis, multiple causes of SCS explantation with associated cost were analyzed. Further attention will need to be focused on minimizing infection and device related complication as two of the most common reasons for removal with significant impact on healthcare resource utilization.

    Patient Care: Further attention will need to be focused on minimizing infection and device related complication as two of the most common reasons for removal with significant impact on healthcare resource utilization.

    Learning Objectives: Further attention will need to be focused on minimizing infection and device related complication as two of the most common reasons for removal with significant impact on healthcare resource utilization.

    References:

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