Korean J Pain.  2025 Jan;38(1):51-57. 10.3344/kjp.24209.

The actual duration of spinal cord stimulator use in patients with complex regional pain syndrome: a Korean nationwide cohort study

• Song IA
• Lee JH
• Han WK
• Nahm FS

• KMID: 2563871
• DOI: http://doi.org/10.3344/kjp.24209

Abstract

Background
Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients with complex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantation due to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPS patients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration of SCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the National Healthcare Insurance Database.
Methods
Adult patients (age ≥ 18) with CRPS who underwent permanent SCS implantation between 2014 and 2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts of age, sex, hospital type, and insurance type.
Results
Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95% confidence interval [CI]: 4.0–4.8) years. Male patients retained SCSs longer than female patients (4.7 vs. 4.0 years, P = 0.014), and veterans’ healthcare beneficiaries showed the longest duration of SCS use (median 6.9 [95% CI: 4.6–7.8] years). Age and hospital type did not affect the duration of SCS use (P = 0.381 and P = 0.122, respectively).
Conclusions
The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost and invasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risks and benefits.

Keyword

Complex Regional Pain Syndromes; Duration of Therapy; Epidemiologic Studies; Insurance Claim Review; Patient Satisfaction; Spinal Cord Stimulation

Figure

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  Fig. 1 CONSORT (Consolidated Standards of Reporting Trials) diagram.

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  Fig. 2 Survival curves showing the difference in the duration of spinal cord stimulator (SCS) use according to sex. Male patients retained SCS longer than female patients (4.7 vs. 4.0 yr, P = 0.014, log-rank test).

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  Fig. 3 Survival curves showing the difference in the duration of spinal cord stimulator (SCS) use according to insurance type. Beneficiaries of healthcare for veterans showed the longest duration of SCS use compared to National Health Insurance and Medical Aid beneficiaries (P = 0.013, log-rank test).

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