Presented at the 2013 AAPM Annual Meeting « Back

State of the Field Survey: Spinal Cord Stimulator Use by Academic Pain Medicine Practices

Gary P. Laux, DO, gboom22@yahoo.com¹, Christopher Gharibo, MD¹, Eric Kim, MD², Christopher Sellars, DO³, (1) New York University, New York, New York, (2) NYU School of Medicine, New York, New York, (3) Private Practice, Roslyn, New York

Introduction: This study is an update on the evolution of Spinal Cord Simulator practice trends and preferences. Results from a similar survey, “The State of Implantable Pain Therapies in the United Sates: A Nationwide Survey of Academic Teaching Programs,” were published by Fanciullo et al. in 1999. Results from this previous study showed an agreement on the usefulness of Spinal Cord Stimulation but, some disparity on resident training, technique, and protocol of implantation. Materials and Methods: Ninety-three Pain Fellowship programs in the United States were identified from www.acgme.org. A 37-question survey was designed on Physician demographics, training, and implantation. IRB approval was obtained. 93 programs were surveyed using email. Nonresponders were contacted at 2, 4, 6, and 12 weeks. Results: Fifty programs (53%) responded. All of the responding programs reported implanting SCS. Annual implants ranged from six to 200. Fellowship was cited as the most valuable source for learning implantation, followed by manufacturer workshops, and conferences. All programs reported manufacture representative involvement. Program directors were neutral to manufacture provided training. All responders did not admit trials overnight. The average length of trial was 4 to 7 days. SCS that were permanently placed were done on an outpatient basis. Forty-six (92%) of responders reported that company representatives reprogram the SCS parameters when indicated. The most common indication for SCS was Failed Back Syndrome followed by Complex Regional Pain Syndrome. Conclusion: Spinal Cord Stimulation implantation is more widespread since 1999, with more manufacturer involvement. References: 1) Fanciullo G, Rose R, Lunt P, Whalen P, Ross E. The State of Implantable Pain Therapies in the United States: A Nationwide Survey of Academic Teaching programs. Regional anesthesia and pain management. 1999;88:1311-6 2) L. Atkinson, S.R. Sundaraj, C. Brooker, J. O’Callaghan, P. Teddy, J. Salmon, T. Semple, P.M. Majedi. (2011) Recommendations for patient selection in spinal cord stimulation. Journal of Clinical Neuroscience 18:10, 1295-1302 3) Judith A. Turner, Richard A. Deyo, John D. Loeser. (2007) Spinal cord stimulation: Stimulating questions. Pain 132:1-2, 10-11 4) Anthony W. Lee, Julie G. Pilitsis. (2006) Spinal cord stimulation: indications and outcomes. Neurosurgical FOCUS 21:6, 1-6 5) Nathaniel C. Sears, Andre G. Machado, Sean J. Nagel, Milind Deogaonkar, Michael Stanton-Hicks, Ali R. Rezai, Jaimie M. Henderson. (2011) Long-Term Outcomes of Spinal Cord Stimulation With Paddle Leads in the Treatment of Complex Regional Pain Syndrome.

Funding: None

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