Authors (including presenting author) :
Chan CW (1), Lau YC (1), Ng WYS (1), Hui KM (1)
Affiliation :
(1) Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital
Introduction :
Spinal cord stimulation (SCS) is a well-established therapeutic modality for the treatment of chronic pain. Around the world, 34,000 patients undergo SCS implantation per year. SCS modulates the pain signals leading to pain relief by delivering electrical stimulation to the dorsal column of the spinal cord. The Queen Mary Hospital has introduced the SCS services since 2014 with standardized protocols with comprehensive pre- and post-operative outcome assessments. Major indications include persistent back pain after surgery, complex regional pain syndrome, peripheral vascular disease and painful diabetes peripheral neuropathy and other neuropathic pain conditions.
Objectives :
To evaluate the cost-effectiveness of SCS in chronic pain patients.
Methodology :
This was a retrospective analysis of 26 patients who underwent SCS implantation from 2014 to 2021 in the Department of Anaesthesia, Pain and Perioperative Medicine, Queen Mary Hospital. Outcome measures include pain severity and interference, health-related quality of life, analgesic consumption. Pain severity and interference were evaluated by the Brief Pain Inventory (BPI). Both the EQ-5D-5L index value and the 36-Item Short Form Survey (SF-36) were employed for assessment of health-related quality of life. Analgesic consumption was quantified by the morphine equivalent dose (MED). The above parameters were assessed at baseline and 1-, 3-, 6- and 12-months post implantation.
Result & Outcome :
Pain Severity -- About 50% pain reduction was achieved for all cases. Analgesic Consumption -- There was 45%-50% reduction in opioid consumption for all cases. Pain Interference -- About 40-50% reduction of pain interference was achieved for all cases. Health- related quality of life -- There was about 300% improvement of EQ-5D-5L index and Physical Component Scores derived from SF-36 for all cases. This signifies better quality of life and physical capability respectively. Conclusion: SCS is a cost-effective and innovative pain management in reducing pain, improving health-related quality of life and decreasing opioid consumption. All these can reduce medical service utilization, reducing the burden to health care system.
