Data was excluded if it described products that were not approved and available for patients to use in the United States in 2020 for the intended implantation in spine. Searches included terms such as “spinal cord stimulation” “dorsal column stimulation.” Title and abstracts were iteratively reviewed for relevance with particular emphasis placed on high-quality health-care market assessments and product details provided by either device manufactures or independent, non-biased sources (e.g., FDA and other government agencies). Internet search tools including MEDLINE, EMBASE, Google scholar, and Google were used to identify SCS products. As such, the study did not require Internal Review Board approval. This study only gathered data that was publicly available. The intention of the review is that it will be a periodically updated resource that will reflect changes in available SCS products. The purpose of this review is to succinctly present the unique and differentiating aspects of commonly available SCS systems currently available on the US market. There exists a number of different products available in the US, each with its own unique features, indications, and limitations. The rapid development of SCS systems over time necessitate continuously updated reviews of available hardware ( 7). The utilization of SCS therapy for the treatment of chronic painful conditions continues in the US due to well-documented efficacy. $3,994) but increases in health-care-related quality of life and EuroQol-5D (EQ-5D) scores at 6 months ( 6). The use of SCS for the treatment of neuropathic leg and LBP was associated with higher upfront costs compared to conventional medical therapy ($19,486 vs. The use of older, non-rechargeable implanted pulse generators (IPGs) was associated with similar incremental cost utilization ratio (ICUR) compared to surgical reoperation for the treatment of LBP (0.59 vs. SCS represents a continuously evolving technology with evidence for cost-effective management of cLBP. The two major considerations when choosing a spinal cord stimulation (SCS) system are efficacy, which is often equivalent to spine surgery, and cost, which is substantially less than spine surgery. The 12 month health-care expenditures of adult patients with LBP in the US was found to be $25,613 (95% confidence interval $25,569–$25,657) among patients who underwent spine surgery compared to $795 ($790–800) among patients who chose non-surgical treatments ( 4). The treatment of cLBP pain represents a major financial burden on the US health-care system. There is concern that as the US population ages and attains increasing risk factors for the development of cLBP, there will be a need for increased treatments ( 3). The lifetime prevalence of acute LBP is nearly 80% in the United States ( 2). Several factors have been identified to confer a more than doubling of the adjusted odds ratio (aOR) of cLBP including being between 50 and 69 years old (aOR 2.03–2.07), having less than a high school education (aOR 2.27), having an annual household income < $20,000 (aOR 2.29), income derived primarily from disability (aOR 2.62), depression (aOR 3.30–10.62 depending on severity), sleep disturbances (aOR 3.90), and other medical comorbidities (aOR 2.49–6.09) ( 1). The point prevalence of chronic low back pain (cLBP) among all adults in the United States (US) is 13.1% ( 1). Here we present a brief survey of currently available SCS hardware in the US and the features that make each product unique. Outcomes: As of 2020, there are nine commonly used SCS platforms made by four manufacturers including four SCS units from Abbott, three from Boston Scientific, and one each from Medtronic and Nevro.Ĭonclusions: A working understanding of each SCS product's nuances is needed for selecting the most appropriate device with which to manage chronic pain patients. We then reviewed published device specifications and manuals for comparison of features. Measures: We used market analysis techniques to survey the currently available SCS technology. There are an even greater number of similar and overlapping features between SCS. Each marketed stimulator has several unique features, indications, and limitations, which distinguish one from the other and makes the selection of appropriate hardware possible for optimal patient care.
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