Table 2. Pain and Health Care Utilization 24 Months After Permanent Spinal Cord Stimulator (SCS) Implantation vs Conventional Medical Management (CMM).
| Variable | Follow-up, mo | Total (n = 7560) | SCS (n = 1260) | CMM (n = 6300) |
|---|---|---|---|---|
| Surrogates of pain | ||||
| Average MME | 1-12 | |||
| Mean (SD) | 33.5 (65.5) | 33.0 (60.7) | 33.6 (66.4) | |
| Median (IQR) | 9.6 (0.7-39.1) | 11.8 (1.9-38.2) | 9.0 (0.5-39.2) | |
| Average MME | 13-24 | |||
| Mean (SD) | 28.3 (55.6) | 27.1 (49.2) | 28.5 (56.8) | |
| Median (IQR) | 5.3 (0.0-35.1) | 6.0 (0.0-34.4) | 5.2 (0.0-35.1) | |
| No. of opioid scripts | 1-12 | |||
| Mean (SD) | 8.3 (8.2) | 8.9 (7.8) | 8.2 (8.2) | |
| Median (IQR) | 7 (1-13) | 7 (2-13) | 6 (1-13) | |
| No. of opioid scripts | 13-24 | |||
| Mean (SD) | 7.4 (8.0) | 7.4 (7.6) | 7.4 (8.0) | |
| Median (IQR) | 5 (0-12) | 5 (0-12) | 5 (0-12) | |
| Chronic opioid use | 1-12 | 3952 (52.3) | 692 (54.9) | 3260 (51.8) |
| 13-24 | 3615 (47.8) | 617 (49.0) | 2998 (47.6) | |
| Long-acting opioid use | 1-12 | 1449 (19.2) | 284 (22.5) | 1165 (18.5) |
| 13-24 | 1259 (16.7) | 231 (18.3) | 1028 (16.3) | |
| High MME | 1-12 | 3984 (52.7) | 815 (64.7) | 3169 (50.3) |
| 13-24 | 3318 (43.9) | 563 (44.7) | 2755 (43.7) | |
| Epidural and facet corticosteroid injections | 1-12 | 2693 (35.6) | 273 (21.7) | 2420 (38.4) |
| 13-24 | 1895 (25.1) | 314 (24.9) | 1581 (25.1) | |
| Radiofrequency ablation | 1-12 | 644 (8.5) | 67 (5.3) | 577 (9.2) |
| 13-24 | 494 (6.5) | 72 (5.7) | 422 (6.7) | |
| Advanced imaging | 1-12 | 2440 (32.3) | 367 (29.1) | 2073 (32.9) |
| 13-24 | 2194 (29.0) | 357 (28.3) | 1837 (29.2) | |
| Spine surgery | 1-12 | 1364 (18.0) | 179 (14.2) | 1185 (18.8) |
| 13-24 | 957 (12.7) | 148 (11.8) | 809 (12.8) | |
| Pharmacologic treatment during follow-up | ||||
| NSAIDs | 1-12 | 2944 (38.9) | 476 (37.8) | 2468 (39.2) |
| 13-24 | 2674 (35.4) | 442 (35.1) | 2232 (35.4) | |
| Muscle relaxants | 1-12 | 3158 (41.8) | 558 (44.3) | 2600 (41.3) |
| 13-24 | 2909 (38.5) | 495 (39.3) | 2414 (38.3) | |
| Systemic steroids | 1-12 | 2614 (34.6) | 422 (33.5) | 2192 (34.8) |
| 13-24 | 2532 (33.5) | 444 (35.2) | 2088 (33.1) | |
| TCA/SNRI antidepressants | 1-12 | 2397 (31.7) | 412 (32.7) | 1985 (31.5) |
| 13-24 | 2305 (30.5) | 419 (33.3) | 1886 (29.9) | |
| Gabapentinoids | 1-12 | 3996 (52.9) | 681 (54.1) | 3315 (52.6) |
| 13-24 | 3714 (49.1) | 671 (53.3) | 3043 (48.3) | |
| Benzodiazepines | 1-12 | 2702 (35.7) | 451 (35.8) | 2251 (35.7) |
| 13-24 | 2407 (31.8) | 371 (29.4) | 2036 (32.3) | |
| Health care utilization and costs, $ | ||||
| All-cause cost of care | ||||
| Total costs, PMPM | Baseline | |||
| Mean (SD) | 2138 (4241) | 1993 (3487) | 2167 (4376) | |
| Median (IQR) | 1060 (557-2253) | 1139 (619-2142) | 1045 (544-2283) | |
| Follow-up total costs, PMPM | 1-12 | |||
| Mean (SD) | 2789 (4220) | 5531 (4188) | 2240 (4008) | |
| Median (IQR) | 1500 (649-3641) | 4488 (3319-6436) | 1182 (559-2552) | |
| Follow-up total costs, PMPM | 13-24 | |||
| Mean (SD) | 2120 (3682) | 2171 (2845) | 2109 (3827) | |
| Median (IQR) | 1070 (479-2434) | 1263 (548-2638) | 1035 (464-2398) | |
| Medical costs, PMPM | Baseline | |||
| Mean (SD) | 1550 (3571) | 1389 (3242) | 1582 (3632) | |
| Median (IQR) | 625 (310-1429) | 679 (363-1300) | 613 (300-1464) | |
| Follow-up medical costs, PMPM | 1-12 | |||
| Mean (SD) | 2184 (3492) | 4916 (3917) | 1638 (3127) | |
| Median (IQR) | 921 (362-2932) | 3910 (2987-5616) | 690 (307-1738) | |
| Follow-up medical costs, PMPM | 13-24 | |||
| Mean (SD) | 1498 (2785) | 1557 (2487) | 1486 (2840) | |
| Median (IQR) | 595 (253-1618) | 695 (278-1786) | 579 (247-1583) | |
| Outpatient pharmacy costs, PMPM | Baseline | |||
| Mean (SD) | 588 (2215) | 604 (1064) | 585 (2379) | |
| Median (IQR) | 229 (86-602) | 281 (102-665) | 219 (83-590) | |
| Follow-up outpatient pharmacy costs, PMPM | 1-12 | |||
| Mean (SD) | 604 (2249) | 615.1 (1120) | 602 (2412) | |
| Median (IQR) | 240 (93-610) | 290 (111-648) | 231 (90-601) | |
| Follow-up outpatient pharmacy costs, PMPM | 13-24 | |||
| Mean (SD) | 622 (2282) | 614 (1097) | 623.6 (2451) | |
| Median (IQR) | 232 (87-604) | 283 (108-662) | 223 (85-590) | |
| All-cause health care resource utilization | ||||
| Follow-up inpatient stays | 1-12 | |||
| Mean (SD) | 0.3 (0.8) | 0.3 (0.7) | 0.3 (0.8) | |
| Median (IQR) | 0 (0-0) | 0 (0-0) | 0 (0-0) | |
| Follow-up inpatient stays | 13-24 | |||
| Mean (SD) | 0.3 (0.8) | 0.3 (0.7) | 0.3 (0.8) | |
| Median (IQR) | 0 (0-0) | 0 (0-0) | 0 (0-0) | |
| Follow-up ED stays | 1-12 | |||
| Mean (SD) | 1.0 (2.2) | 0.9 (2.0) | 1.0 (2.2) | |
| Median (IQR) | 0 (0-1) | 0 (0-1) | 0 (0-1) | |
| Follow-up ED stays | 13-24 | |||
| Mean (SD) | 0.9 (2.0) | 0.9 (1.8) | 0.9 (2.1) | |
| Median (IQR) | 0 (0-1) | 0 (0-1) | 0 (0-1) | |
| Follow-up ED, d | 1-12 | |||
| Mean (SD) | 1.2 (3.0) | 1.2 (2.7) | 1.2 (3.0) | |
| Median (IQR) | 0 (0-1) | 0 (0-1) | 0 (0-1) | |
| Follow-up ED, d | 13-24 | |||
| Mean (SD) | 1.2 (3.0) | 1.1 (2.4) | 1.2 (3.1) | |
| Median (IQR) | 0 (0-1) | 0 (0-1) | 0 (0-1) | |
| Office visits | Baseline | |||
| Mean (SD) | 12.1 (9.0) | 13.3 (8.7) | 11.9 (9.0) | |
| Median (IQR) | 10 (6-16) | 11 (7-17) | 10 (6-15) | |
| Follow-up office visits | 1-12 | |||
| Mean (SD) | 22.5 (16.6) | 23.0 (16.2) | 22.5 (16.7) | |
| Median (IQR) | 19 (11-29) | 20 (12-30) | 19 (11-29) | |
| Follow-up office visits | 13-24 | |||
| Mean (SD) | 21.1 (16.8) | 22.4 (18.0) | 20.8 (16.5) | |
| Median (IQR) | 17 (10-27) | 18 (11-29) | 17 (10-27) | |
Abbreviations: ED, emergency department; MME, morphine milligram equivalent; NSAID, nonsteroidal anti-inflammatory drug; PMPM, per member per month; SNRI, serotonin and norepinephrine reuptake inhibitor; TCA, tricyclic antidepressant.