Target Audience: Clinicians implanting, managing, or identifying patients for SCS therapy
As a result of participating in this activity, learners will be better able to:
Compare and contrast technical differences of neurostimulation devices
Apply an improved understanding of SCS parameters to patient selection and trialing
Tolerance & Loss of Efficacy
David Provenzano, MD
Surgical Revisions vs.
Corey W. Hunter, MD
Developing Electrophysiological Models of Disease
Peter S. Staats, MD, MBA, FIPP
A recent studies have shown that 34% of patients with a spinal cord stimulator (SCS) will undergo surgical revision of the implant with a median time to first revision of 16 months. Additionally, 30-53% of patients with a SCS device will have the device explanted with a median time to removal of 39 months.
The most common explanations for explant are: ineffective pain control or lack/loss of efficacy (28-43.9%%), followed by biological complications (20.2-26.6%), paresthesia limitation or side effects (26.6%), and hardware complications/device malfunction (13.3-46%).
High variations in specialty-based trial-to-implant ratios for implanting physicians indicate opportunities for improvement with patient selection, surgical technique, and technical understanding of SCS mechanisms of action.
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