Spinal Cord Stimulator (SCS) Placement: Examining Outcomes Between the Open and Percutaneous Approach.

Humans Spinal Cord Stimulation / adverse effects Pain Management / methods Reoperation Spinal Cord / surgery Retrospective Studies
SCS open approach outcomes percutaneous approach spinal cord stimulator

Journal

Neuromodulation : journal of the International Neuromodulation Society
ISSN: 1525-1403
Titre abrégé: Neuromodulation
Pays: United States
ID NLM: 9804159

Informations de publication

Date de publication:
Jul 2023
Historique:
received: 13 09 2022
revised: 27 10 2022
accepted: 11 11 2022
medline: 10 7 2023
pubmed: 17 12 2022
entrez: 16 12 2022
Statut: ppublish

Résumé

Spinal cord stimulator (SCS) placement has been gaining traction as an approach to modulate pain levels for several different chronic pain conditions. This procedure can be performed via a percutaneous or open approach. Data regarding SCS complications are relatively limited. The purpose of this study was to leverage a large national database to examine outcomes between the percutaneous and open SCS placement approaches. Outcomes in this study include length of stay (LOS), complication rates, reoperation rates, and 1-year readmission rates. Inclusion criteria for the current study is SCS placement between 2015 and 2020, with receipt of an SCS using either a percutaneous approach or an open laminectomy based approach. Encounters included were limited to true SCS placement, such that trial placements were not included in the study. Univariate statistics and multivariable logistic regression was performed to compare outcomes between cohorts. Total SCS case volumes were 9935 between the percutaneous (n = 4477, 45.1%) and open (n = 5458, 54.9%) approach. Patients receiving the percutaneous approach were found to have a mean decrease in LOS of 9.91 hours when compared to those receiving the open approach. The percutaneous approach was significantly associated with the need for reoperation within one year compared to the open approach (odds ratio [OR]: 0.663, p < 0.001), as well as with the need for readmission within 30 days (51.2% vs 40.2%, OR: 0.759, p < 0.001). The open approach, when compared to the percutaneous approach, had a longer mean LOS, lower outpatient discharge rates, and higher odds of experiencing an operative complication in comparison to the percutaneous approach. The percutaneous approach had relatively increased odds of thirty-day readmission, although no significant difference in one-year readmission or removal was demonstrated.

Sections du résumé

BACKGROUND BACKGROUND
Spinal cord stimulator (SCS) placement has been gaining traction as an approach to modulate pain levels for several different chronic pain conditions. This procedure can be performed via a percutaneous or open approach. Data regarding SCS complications are relatively limited.
OBJECTIVE OBJECTIVE
The purpose of this study was to leverage a large national database to examine outcomes between the percutaneous and open SCS placement approaches. Outcomes in this study include length of stay (LOS), complication rates, reoperation rates, and 1-year readmission rates.
MATERIALS AND METHODS METHODS
Inclusion criteria for the current study is SCS placement between 2015 and 2020, with receipt of an SCS using either a percutaneous approach or an open laminectomy based approach. Encounters included were limited to true SCS placement, such that trial placements were not included in the study. Univariate statistics and multivariable logistic regression was performed to compare outcomes between cohorts.
RESULTS RESULTS
Total SCS case volumes were 9935 between the percutaneous (n = 4477, 45.1%) and open (n = 5458, 54.9%) approach. Patients receiving the percutaneous approach were found to have a mean decrease in LOS of 9.91 hours when compared to those receiving the open approach. The percutaneous approach was significantly associated with the need for reoperation within one year compared to the open approach (odds ratio [OR]: 0.663, p < 0.001), as well as with the need for readmission within 30 days (51.2% vs 40.2%, OR: 0.759, p < 0.001).
CONCLUSION CONCLUSIONS
The open approach, when compared to the percutaneous approach, had a longer mean LOS, lower outpatient discharge rates, and higher odds of experiencing an operative complication in comparison to the percutaneous approach. The percutaneous approach had relatively increased odds of thirty-day readmission, although no significant difference in one-year readmission or removal was demonstrated.

Identifiants

DOI: 10.1016/j.neurom.2022.11.010 PMID: 36526545
pubmed: 36526545
pii: S1094-7159(22)01372-1
doi: 10.1016/j.neurom.2022.11.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1067-1073

Informations de copyright

Copyright © 2022 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Alexander Beletsky (A)

Department of Anesthesiology, HCA Healthcare, Riverside Community Hospital, Riverside, CA, USA. Electronic address: alexander.beletsky@hcahealthcare.com.

Cherry Liu (C)

Department of Anesthesiology, HCA Healthcare, Riverside Community Hospital, Riverside, CA, USA.

Kim Vickery (K)

Department of Anesthesiology, HCA Healthcare, Riverside Community Hospital, Riverside, CA, USA.

Nutan Winston (N)

Department of Anesthesiology, HCA Healthcare, Riverside Community Hospital, Riverside, CA, USA.

Munish Loomba (M)

Department of Anesthesiology, HCA Healthcare, Riverside Community Hospital, Riverside, CA, USA.

Rodney A Gabriel (RA)

Division of Pain, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA; Division of Regional Anesthesia, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA; Division of Perioperative Informatics, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.

Jeffrey Chen (J)

Division of Pain, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Spinal Cord Stimulator (SCS) Placement:...
questionsmedicales.fr › Thérapeutique › Techniques de physiothérapie › Électrothérapie › Stimulation de la moelle épinière › Spinal Cord Stimulator (SCS) Placement:...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Prise en charge de la maladie › Gestion de la douleur › Spinal Cord Stimulator (SCS) Placement:...
questionsmedicales.fr › Procédures de chirurgie opératoire › Réintervention › Spinal Cord Stimulator (SCS) Placement:...
questionsmedicales.fr › Système nerveux › Système nerveux central › Moelle spinale › Spinal Cord Stimulator (SCS) Placement:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Spinal Cord Stimulator (SCS) Placement:...