The actual duration of spinal cord stimulator use in patients with complex regional pain syndrome: a Korean nationwide cohort study

Abstract

Background: Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients withcomplex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantationdue to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPSpatients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration ofSCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the NationalHealthcare Insurance Database. Methods: Adult patients (age ≥ 18) with CRPS who underwent permanent SCS implantation between 2014 and2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts ofage, sex, hospital type, and insurance type. Results: Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95%confidence interval [CI]: 4.0–4.8) years. Male patients retained SCSs longer than female patients (4.7 vs . 4.0years, P = 0.014), and veterans’ healthcare beneficiaries showed the longest duration of SCS use (median 6.9[95% CI: 4.6–7.8] years). Age and hospital type did not affect the duration of SCS use (P = 0.381 and P = 0.122,respectively). Conclusions: The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost andinvasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risksand benefits.