[Cost-benefit evaluation of spinal cord stimulation treatment for failed-back surgery syndrome patients]

Neurochirurgie. 2004 Sep;50(4):443-53. doi: 10.1016/s0028-3770(04)98324-5.
[Article in French]


Background and purpose: Spinal cord stimulation is a well-known treatment of rigorously selected failed-back surgery syndrome patients. Efficacy levels over 50% of pain relief have been reported in long-term studies. The objective of this multicenter prospective evaluation was to analyze the cost to benefit ratio of spinal cord stimulation treatment for failed back surgery syndrome patients.

Methods: Nine hospitals (pain evaluation and treatment centers) were involved in the study. Forty-three patients were selected and implanted between January 1999 and January 2000. For each patient, pre- and post-operative evaluations (6, 12 and 24 months after implantation) were performed to assess pain relief and economical impact on pain treatment costs.

Results: After 24 months, mean 60% pain relief was achieved as assessed with the neuropathic pain score using a Visual Analog Scale (success rate=70%), whereas low-back pain was moderately reduced (29%). The Oswestry Disability questionnaire score was improved by a mean 39%. Costs of pain treatment (medication, consultation, other) are reduced by a mean 64% (1705 Euro) per patient per year.

Conclusions: This study confirms a clear analgesic effect on neuropathic sciatalgia, and moderate attenuation of low-back pain. One particular interest of this study is the medico-economic prospective evaluation showing that the initial cost of the implanted device is compensated by a significant, early, and stable reduction in the cost of associated pain therapies.

Publication types

  • English Abstract
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Electric Stimulation Therapy / adverse effects
  • Electric Stimulation Therapy / economics*
  • Female
  • Humans
  • Low Back Pain / economics*
  • Low Back Pain / surgery
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Treatment Failure