• S Blond, N Buisset, P Dam Hieu, J-P Nguyen, Y Lazorthes, N Cantagrel, B Laugner, F Bellow, M-C Djian, J-L Husson, F Lapierre, and J-L Blanc.
• Service de Neurochirurgie, CHU Salengro, 2, avenue Oscar-Lambret, 59037 Lille. sblond@chru-lille.fr
• Neurochirurgie. 2004 Sep 1;50(4):443-53.

Background And PurposeSpinal cord stimulation is a well-known treatment of rigorously selected failed-back surgery syndrome patients. Efficacy levels over 50% of pain relief have been reported in long-term studies. The objective of this multicenter prospective evaluation was to analyze the cost to benefit ratio of spinal cord stimulation treatment for failed back surgery syndrome patients.MethodsNine hospitals (pain evaluation and treatment centers) were involved in the study. Forty-three patients were selected and implanted between January 1999 and January 2000. For each patient, pre- and post-operative evaluations (6, 12 and 24 months after implantation) were performed to assess pain relief and economical impact on pain treatment costs.ResultsAfter 24 months, mean 60% pain relief was achieved as assessed with the neuropathic pain score using a Visual Analog Scale (success rate=70%), whereas low-back pain was moderately reduced (29%). The Oswestry Disability questionnaire score was improved by a mean 39%. Costs of pain treatment (medication, consultation, other) are reduced by a mean 64% (1705 Euro) per patient per year.ConclusionsThis study confirms a clear analgesic effect on neuropathic sciatalgia, and moderate attenuation of low-back pain. One particular interest of this study is the medico-economic prospective evaluation showing that the initial cost of the implanted device is compensated by a significant, early, and stable reduction in the cost of associated pain therapies.

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