COST-EFFECTIVENESS ANALYSIS OF SPINAL-CORD STIMULATION IN TREATMENT OF FAILED BACK SURGERY SYNDROME

This article presents an analysis of the medical costs of spinal cord stimulation (SCS) therapy in the treatment of patients with failed bac k surgery syndrome (FBSS). We compared the medical costs of SCS therap y with an alternative regimen of surgeries and other interventions. Ex ternally powered (external) and fully internalized (internal) SCS syst ems were considered separately. Clinical management models of each of the therapy alternatives were derived from the clinical literature, re trospective data sets, expert opinion, and published diagnostic and th erapy protocols. No value was placed on pain relief or improvements in the quality of life that successful SCS therapy can generate. We foun d that by reducing the demand for medical care by FBSS patients, SCS t herapy can lower medical costs. On average, given current screening an d efficacy rates, SCS therapy pay for itself within 5.5 years. For tho se patients for whom SCS therapy is clinically efficacious, the therap y pays for itself within 2.1 years. (C) U.S. Cancer Pain Relief Commit tee, 1997.