Spinal cord stimulation

Spinal cord stimulation (SCS) systems involve percutaneous implantation of electrode leads into the epidural space until they reach the dorsal column of the spinal cord.

Spinal cord stimulation (SCS) was first reviewed by the HTA program in 2010.

Searches of SCS medical literature were conducted in 2014, 2016, and 2018 to determine if newly available published evidence could change the original coverage determination. The technology has not been selected for rereview.
In 2022, the HCA director selected SCS for rereview based on published evidence that could change the original coverage determination.

Status: Decision complete

View findings and decision

Why is SCS being reviewed?

Concerns on efficacy (particularly long term), safety and cost regarding Spinal Cord Stimulation (SCS). SCS involves the administration of electrical impulses in the spinal cord via an implanted device. SCS is considered a late or last alternative treatment for painful conditions such as chronic back and leg pain resulting from failed back surgeries, Complex Regional Pain Syndrome (CRPS) and chronic chest pain (angina). Important questions remain regarding the safety, efficacy, and cost-effectiveness of SCS.

Primary criteria ranking

Safety = Medium
Efficacy = High
Cost = Medium

Documentation

Type	Materials
Assessment (2023)	Final key questions Draft evidence report: comment and response Final evidence report Final evidence report: appendices Final findings and decision
Update literature (2018)	Evidence update literature
Update literature (2016)	Evidence update literature
Update literature (2014)	Evidence update literature
Assessment (2010)	Final key questions Draft evidence report: comment and response Draft evidence report: comment and response attachments Final evidence report Final evidence report: appendix Final findings and decision

Assessment timeline

Draft key questions published: April 20, 2023
- Public comment period: April 20 to May 3, 2023
Final key questions published: June 14, 2023
Draft report published: September 1, 2023
- Public comment period: September 1 to October 2, 2023
Final report published: October 24, 2023
HTCC public meeting: November 17, 2023
HTCC public meeting (continued): February 16, 2024
HTCC public meeting (continued): May 17, 2024
Draft findings and decision published: May 21, 2024
- Public comment period: May 21 to June 3, 2024
Final findings and decision published: June 28, 2024

Spinal cord stimulation