Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors

Details

Serval ID
serval:BIB_9E2642F3D3F5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors
Journal
European Journal of Pain
Author(s)
Taylor  R. S., Van Buyten  J. P., Buchser  E.
ISSN
1090-3801 (Print)
Publication state
Published
Issued date
02/2006
Volume
10
Number
2
Pages
91-101
Notes
Journal Article
Review --- Old month value: Feb
Abstract
OBJECTIVE: To review the clinical and cost-effectiveness of spinal cord stimulation (SCS) in the management of patients with complex regional pain syndrome (CRPS) and identify the potential predictors of SCS outcome. DESIGN: Systematic review of the literature and meta-regression. METHODS: Electronic databases were searched for controlled and uncontrolled studies and economic evaluations relating to the use of SCS in patients with either CRPS type I or II. RESULTS: One randomised controlled trial, 25 case series and one cost-effectiveness study were included. In the randomised controlled trial in type I CRPS patients, SCS therapy lead to a reduction in pain intensity at 24 months of follow-up (mean change in VAS score -2.0), whereas pain was unchanged in the control group (mean change in VAS score 0.0) (p<0.001). In the case series studies, 67% (95% CI 51%, 84%) of type I and type II CRPS patients implanted with SCS reported pain relief of at least 50% over a median follow-up period of 33 months. No statistically significant predictors of pain relief with SCS were observed in multivariate meta-regression analysis across studies. An economic analysis based on the randomised controlled trial showed a lifetime cost saving of approximately 58,470 (60,800 US dollars) with SCS plus physical therapy compared with physical therapy alone. The mean cost per quality-adjusted life-year at 12-month follow-up was 22,580 (23,480 US dollars). CONCLUSIONS: SCS appears to be an effective therapy in the management of patients with CRPS type I (Level A evidence) and type II (Level D evidence). Moreover, there is evidence to demonstrate that SCS is a cost-effective treatment for CRPS type I.
Keywords
Complex Regional Pain Syndromes/*economics/*therapy Cost-Benefit Analysis Electric Stimulation Therapy/*economics Humans Prognosis *Spinal Cord
Pubmed
Web of science
Create date
28/01/2008 10:41
Last modification date
20/08/2019 15:04
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