medtronic dorsal column stimulator surgery

The UK National Institute for Health and Care Excellence conclude in their Health Technology Appraisal of the therapy that among a total of 403 implanted patients across all trials examined, four (1%) device removals were required as a result of infection. This has been successfully demonstrated in the case of cardioverter defibrillator and total hip replacement. It is important to note that in device-based therapies, the experience of the implanter impacts significantly on the rate of complications. A review has recommended an 18% budgetary allocation average per patient per annum for the maintenance of the therapy including complication management. Infection is one of the major complications of SCS with incidences of 3.4% to 10%, and is a common cause for removal of the device and failure of therapy. Hardware-related problems such as lead failure and migration are more common than biological complications such as infection, pain, and wound breakdown. The complications of SCS are numerous and incidences of 30% to 40% have been reported in multiple studies. The cost of complications, which is included in the cost of the therapy, has been derived from the patient cohort of the PROCESS study and is estimated at an average of £576 per patient (SD of £1,320).

The Incremental Cost Effectiveness Ratio (ICER) calculated over a 15-year horizon was below £20,000 per quality adjusted life year (QALY). Ī health economic assessment of SCS for the management of chronic neuropathic pain has shown the therapy to be cost-effective. Studies of SCS have shown that the therapy significantly improves the health-related quality of life (HRQoL) of users. Despite incomplete understanding of the mechanism of action, spinal cord stimulation (SCS) has become increasingly popular and its efficacy has been documented in neuropathic pain (level B) as well as ischemic pain, whether due to peripheral vascular or coronary artery disease. The electrical stimulation of the dorsal columns of the spinal cord to induce pain relief was first used in humans in 1967. Serious adverse events such as neurological damage are rare. Hardware-related complications are more commonly observed than biological complications. Spinal cord and peripheral neurostimulation techniques are safe and reversible therapies.

Serious biological complications such as dural puncture headache and neurological damage are rarely observed.Ĭonclusions. Common biological complications include infection and pain over the implant. Other lead related complications such as failure or fracture have also been reported. The commonest hardware-related complication is lead migration.

Adverse events can be subdivided into hardware-related complications and biological complications. The incidence of complications reported varies from 30% to 40% of patients affected by one or more complications.

A review of the major recent publications in the literature on the subjects of spinal cord, occipital, sacral, and peripheral nerve field stimulation was conducted. The aim of this article is to present a review of complications observed in patients treated with neurostimulation techniques. Neuromodulation has recognized complications, although very rarely do these cause long-term morbidity. Spinal cord and peripheral neurostimulation techniques have been practiced since 1967 for the relief of pain, and some techniques are also used for improvement in organ function.

Medtronic dorsal column stimulator surgery