Spinal Cord Stimulators Do Not Reduce Opioid Use in Chronic Pain Patients

The results of a new study suggest that the use of spinal cord stimulators (SCSs) do not reduce opioid use or nonpharmacologic pain interventions compared with conventional medical management (CMM). The results appeared in JAMA Neurology. 

In this retrospective study, researchers assessed a population of 7,560 patients (average age, 63.5, 40.7% male, 59.3%) mean (SD) age was 63.5 (12.5) years, 3080 (40.7%)  male, and 4480 (59.3%) female with incident diagnosis codes for failed back surgery syndrome, complex regional pain syndrome, chronic pain syndrome, and other chronic postsurgical back and extremity pain.

The researchers measured primary chronic pain treatment modalities, including pharmacologic and nonpharmacologic pain interventions, and total costs. Analysis took place from February 2021 to August 2022.

According to the results, patients treated with SCSs had higher odds of chronic opioid use compared with patients treated with CMM  During months 13 to 24, there was no significant difference in chronic opioid use (adjusted odds ratio [aOR], 1.14; 95% CI, 1.01-1.29). Also, almost 18% of patients treated with SCS experienced SCS-related complications within 2 years, and 22.1% had device revisions and/or removals. Overall, total costs of care in the first year were $39,000 higher with SCS than CMM, the researchers noted.

“SCS placement was not associated with a reduction in opioid use or nonpharmacologic pain interventions at 2 years. SCS was associated with higher costs, and SCS-related complications were common,” the researchers concluded.