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
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) | |
| Update literature (2018) | |
| Update literature (2016) | |
| Update literature (2014) | |
| Assessment (2010) |
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