The SCS system consists of 3 components: an electrode array which is implanted in the epidural space overlying the dorsal columns of the spinal cord an implantable pulse generator (IPG) which consists of an electrical generator, battery, transmitter/receiver and a minicomputer, which is placed beneath the skin and controlled transcutaneously by the patient and insulating wiring connecting the electrodes to the IPG. Spinal cord neuromodulation using implantable electrodes placed over the dorsal columns in the epidural space can be an effective strategy for the control of severe, longstanding, neuropathic pain. Safety guidelines do not yet exist however, for implanted electronic spinal cord stimulators (SCS). Given the increasing use of these devices for a broad range of medical applications, recommendations have been developed regarding the safe delivery of RT with such devices in-situ. However, RT can interfere with and potentially damage implanted electronic devices such as cardiac pacemakers or implanted cardioverter-defibrillators (ICD). Health care centers can use this information when planning budgets and cost-versus-benefit ratios.Radiotherapy (RT) is a major cancer treatment modality, applied to approximately 60% of patients at some point in their natural history for curative and palliative intent. It turns out that the added costs amount to about 18 per cent of the initial implantation cost. A second equation calculates the add-on costs of annual maintenance and complications. The authors present a formula that can be used when first calculating the cost of a spinal cord implant. And the third is to study which models function without breaking down and use those instead of poorly designed, short-lasting units. The second is to recognize that different manufacturers charge different selling prices to different geographical markets. Some companies manufacturing these devices are already promising a battery life of 10 to 25 years. One is to develop a rechargeable system that lasts for more than a few years. The are some things that can be done to bring the costs down. Travel costs, lodging, and meals are not included in these figures. Since spinal cord stimulation is not readily available at every hospital, it is necessary for some patients to travel far distances to benefit from this specialized pain control. These costs do not reflect out-of-pocket money spent by patients pursuing this type of treatment. Obviously replacing the batteries is much less costly than a hospitalization for infection or implant failure. Different complications have different average costs associated with them. That doesn’t include the cost of medications used for drug therapy.
The annual maintenance costs cover things like hardware, professional fees (doctors, nurses), X-rays or other advanced imaging studies, pulse generator replacement, and any costs associated with hospitalization for complications. Each time a new patient receives a spinal cord stimulator, the total cost for actively managed patients is increased. The cost of uncomplicated annual care to maintain the system starts at $3500 in Canada, goes to $5000 under Medicare, and tops at $7277 for Blue Cross/Blue Shield patients. But what this study shows for the first time are the added costs of maintenance, upkeep, and complications. That figure does include the preoperative evaluation and the trial before permanent implantation. That’s a reasonable request considering the basic cost of the unit and implantation ranges from $21,595 to $57,800 (depending on who is paying for it). Third party payers such as private insurance, Blue Cross/Blue Shield (health maintenance plan), and Medicare have asked physicians to show that the benefit of this treatment is worth the cost.
But before we go too far with this treatment tool, it’s important to look at the total cost (not just the initial implantation cost). The success of this treatment has increased its use for chronic pain patients in the United States and Canada. It must be done on a trial basis first before the stimulator is permanently implanted. SCS is generally only used if nothing else in treatment seems to be working. In essence, the stimulator masks the pain. The electrical impulses from the stimulator override the pain messages so the person doesn’t feel the pain so acutely or so intensely. A stimulator is implanted into the patient’s body, which then sends out impulses to interrupt the pain signals and prevent them from reaching the brain. For over 30 years now, doctors have used spinal cord stimulation (SCS), also called neurostimulation, to help relieve chronic neuropathic (nerve) pain.