• Anshit Goyal, Archis R Bhandarkar, Panagiotis Kerezoudis, Tim J Lamer, Halena M Gazelka, Allan J Belzberg, Richard B North, and Mohamad Bydon.
• Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
• World Neurosurg. 2021 Mar 1; 147: e171-e188.

ObjectiveIn this study, we sought to characterize contemporary trends in cost and utilization of spinal cord stimulation (SCS).MethodsThe Healthcare Cost and Utilization Project-National Inpatient Sample was queried for inpatient admissions from 2008 to 2014 where SCS was performed. We then determined the rates and costs of SCS performed in this time frame to treat diagnoses that we classified as device-related complications, degenerative spine disease, pain syndromes, and neuropathies/neuritis/nerve lesions. Least-squares regression was performed to determine the yearly trends for each indication adjusted by the total number of yearly hospitalizations for that diagnosis.ResultsWe identified a total of 6876 admissions in whom an SCS was performed. The overall rate of inpatient SCS procedures performed has decreased by 45% from 2008 to 2014 (14.0 to 7.7 procedures per 100,000 admissions). Adjusted analysis for yearly trends also demonstrated a declining trend for all indications; however, this was not found to be statistically significant, except for device-related complications (P = 0.004). The median inflation-adjusted cost of an admission where SCS was performed increased slightly by 7.4% from $26,200 (IQR: $16,700-$33,800) in 2008 to $28,100 (IQR: $19,600-$36,900) in 2014. Billed hospital charges demonstrated a significant increase with median inflation-adjusted admission charge of $66,068 in 2008 to $110,672 in 2014.ConclusionsDespite a declining contemporary trend in inpatient SCS, an increase was noted in admission costs and hospital charges. A significant declining trend was noted in revision SCS implantations due to device-related complications.Copyright © 2020 Elsevier Inc. All rights reserved.

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