Background: Spinal cord stimulation (SCS) is an effective treatment option to relieve chronic intractable pain, and failed back surgery syndrome (FBSS) is a key indication.
Objectives:The objective of the current study was to analyze the cost consequences of using non-rechargeable (NR)-SCS and rechargeable (R)-SCS.
Methods:Real data taken from a review of 86 patients were used to simulate costs and review which patients might have benefitted more from R-SCS. Calculations were made to see what is the impact from a monetary point of view.Results: On average, NR-SCS devices lasted for 58 months (M). Only 14 patients were not eligible to receive an R-SCS implant. We found that using R-SCS batteries would save up to €56.322 on average over a patient's life expectancy, which means a saving of 43% compared to using NR-SCS systems. In our analysis, we found that if R-SCS implants were used instead of NR-SCS batteries, a saving of €5,735,334.23 over patients' life expectancy would be made, which represented a 63% saving to the public health system. We found that R-SCS was cost-beneficial from second year compared to NR-SCS, saving up to 70% when patients are implanted for 9 years.
Conclusions:This cost-consequences analysis suggests that R-SCS implants are more cost-beneficial than NR-SCS systems in wellselected patient candidates for this type of treatment.
Introduction: The situation generated in the health system by the COVID-19 pandemic has provoked a crisis involving the necessity to cancel non-urgent and oncologic activity in the operating room and in day-today practice. As the situation continues, the need to reinstate attention for patients with chronic pain grows. The restoration of this activity has to begin with on-site appointments and possible surgical procedures. On-site clinical activity has to guarantee the safety of patients and health workers.
Background: Epiduroscopy is a minimally invasive technique that enables diagnosis and treatment within the epidural
space with direct vision. Previously reported complications of this technique have been mostly mild neurological
complications of a transitory nature. In the present case, we describe a serious complication
following an epiduroscopy, resulting in death.
Case Report: The patient was a 39-year-old woman with lower back and lower limb pain who had undergone 3 surgical
interventions previously on the lumbar spine. Only limited results from conservative and interventional
treatment had been observed. She underwent an epiduroscopy in the Pain Management Unit. Immediately
after the procedure, which was completed without incident, the patient presented neurological symptoms
with areflexic paraplegia and a loss of sensation in the lower limbs and the upper left limb. Imaging tests
identified signs of craniospinal hypotension that progressed slowly despite medical intervention. Ventricular
dilation and cerebral edema without remission occurred, which ultimately caused the patient’s death 2
months after admission to the intensive care unit.
Conclusion: Epiduroscopy has the potential to present adverse effects and complications. A thorough evaluation of
the clinical history and the imaging tests are advisable
Key words: Complications, epiduroscopy, low back pain, spinal cord, spinal endoscopy
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