Practice Point

Nature Clinical Practice Neurology (2008) 4, 472-473
doi:10.1038/ncpneuro0865  
Received 13 May 2008 | Accepted 9 June 2008 | Published online: 22 July 2008

Spinal cord stimulation for failed back surgery syndrome—does it work and is it cost-effective?

Daniel M Sciubba* and Ziya L Gokaslan

Correspondence *Meyer Building 8-161, 600 North Wolfe Street, Baltimore, MD 21287, USA

Email
 dsciubb1@jhmi.edu

This Practice Point commentary discusses a study by Manca et al. that aimed to investigate the health-related quality-of-life and cost implications of spinal cord stimulation (SCS) plus nonsurgical conventional medical management (CMM) versus nonsurgical CMM alone. Manca et al. reported that the mean total 6-month health-care cost in the SCS group was significantly higher than that in the CMM alone group. However, the gain in health-related quality of life for patients undergoing SCS was significantly greater than that for patients undergoing CMM alone over this same period. In addition, patients in the SCS group used fewer analgesics and nondrug pain treatments (e.g. physical therapy), thus offsetting the upfront costs of SCS by 15%. The relevance of this study in providing an evaluation of health-care expenditures directed at treating low back pain relative to actual treatment outcomes is discussed.

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