Trends in Utilization and Cost of Spinal Cord Stimulation Surgery: Insights From the National Inpatient Sample Database, 2008 to 2014. (1st September 2019)

• Record Type: Journal Article
• Authors: Goyal, Anshit; Bhandarkar, Archis; Alvi, Mohammed A; Yolcu, Yagiz U; Bydon, Mohamad
• Is Part Of: Neurosurgery. Volume 66(2010)Supplement 1
• Publication Date: 2019-09-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz310_130
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: In this study, we sought to determine the trends in cost and utilization of spinal cord stimulation (SCS) as well as better understand the drivers of cost associated with this procedure. METHODS: The National Inpatient Sample (NIS) was queried for inpatient admissions between 2008 and 2014 where SCS was performed. We then determined the rates and costs of SCS performed in this time frame to treat diagnoses that we classified as cervical-level pathologies, thoracic-level pathologies, lumbosacral-level pathologies, chronic pain syndromes, or device-related complications. Multivariable linear regression was then performed to establish the particular patient, hospital, and clinical factors driving costs of SCS admissions. RESULTS: A total of 6209 admissions were included in this analysis. The overall rate of SCS procedures performed has decreased by 44% from 2008 to 2014 (139 to 77 procedures per million inpatient admissions). The estimated national economic burden of SCS has also decreased by 28% in this time span ($115 million-$83 million). Lumbosacral-level pathologies, such as postlaminectomy syndrome of the lumbar spine, accounted for the greatest share of inpatient admissions (36% in 2014) and the greatest share of the cost associated with SCS (37% in 2014). Chronic pain syndromes accounted for the second largest share of inpatient admissions (24% in 2014) and costs (23% in 2014). Length of stay, a primary diagnosis of device-related complications, and the comorbidities of obesity and depression emerged as top predictors of admission cost ( P < .001). CONCLUSION: In this analysis from a national database, we determined that the rate and costs associated with inpatient SCS have been decreasing and also found several patient, hospital, and clinical factors to target for further cost-reduction efforts.