Skip to main content
Duke University Libraries
DukeSpace Scholarship by Duke Authors
  • Login
  • Ask
  • Menu
  • Login
  • Ask a Librarian
  • Search & Find
  • Using the Library
  • Research Support
  • Course Support
  • Libraries
  • About
View Item 
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Impact of Spinal Cord Stimulation on Opioid Dose Reduction: A Nationwide Analysis.

Thumbnail
View / Download
778.5 Kb
Date
2020-12
Authors
Adil, Syed M
Charalambous, Lefko T
Spears, Charis A
Kiyani, Musa
Hodges, Sarah E
Yang, Zidanyue
Lee, Hui-Jie
Rahimpour, Shervin
Parente, Beth
Greene, Kathryn A
McClellan, Mark
Lad, Shivanand P
Show More
(12 total)
Repository Usage Stats
24
views
4
downloads
Abstract
<h4>Background</h4>Opioid misuse in the USA is an epidemic. Utilization of neuromodulation for refractory chronic pain may reduce opioid-related morbidity and mortality, and associated economic costs.<h4>Objective</h4>To assess the impact of spinal cord stimulation (SCS) on opioid dose reduction.<h4>Methods</h4>The IBM MarketScan® database was retrospectively queried for all US patients with a chronic pain diagnosis undergoing SCS between 2010 and 2015. Opioid usage before and after the procedure was quantified as morphine milligram equivalents (MME).<h4>Results</h4>A total of 8497 adult patients undergoing SCS were included. Within 1 yr of the procedure, 60.4% had some reduction in their opioid use, 34.2% moved to a clinically important lower dosage group, and 17.0% weaned off opioids entirely. The proportion of patients who completely weaned off opioids increased with decreasing preprocedure dose, ranging from 5.1% in the >90 MME group to 34.2% in the ≤20 MME group. The following variables were associated with reduced odds of weaning off opioids post procedure: long-term opioid use (odds ratio [OR]: 0.26; 95% CI: 0.21-0.30; P < .001), use of other pain medications (OR: 0.75; 95% CI: 0.65-0.87; P < .001), and obesity (OR: 0.75; 95% CI: 0.60-0.94; P = .01).<h4>Conclusion</h4>Patients undergoing SCS were able to reduce opioid usage. Given the potential to reduce the risks of long-term opioid therapy, this study lays the groundwork for efforts that may ultimately push stakeholders to reduce payment and policy barriers to SCS as part of an evidence-based, patient-centered approach to nonopioid solutions for chronic pain.
Type
Journal article
Subject
Humans
Opioid-Related Disorders
Analgesics, Opioid
Retrospective Studies
Adult
Middle Aged
Female
Male
Pain Management
Chronic Pain
Spinal Cord Stimulation
Permalink
https://hdl.handle.net/10161/23905
Published Version (Please cite this version)
10.1093/neuros/nyaa353
Publication Info
Adil, Syed M; Charalambous, Lefko T; Spears, Charis A; Kiyani, Musa; Hodges, Sarah E; Yang, Zidanyue; ... Lad, Shivanand P (2020). Impact of Spinal Cord Stimulation on Opioid Dose Reduction: A Nationwide Analysis. Neurosurgery, 88(1). pp. 193-201. 10.1093/neuros/nyaa353. Retrieved from https://hdl.handle.net/10161/23905.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
  • Scholarly Articles
More Info
Show full item record

Scholars@Duke

Lad

Shivanand Lad

Professor of Neurosurgery
Dr. Nandan Lad is a neurosurgeon, scientist, and entrepreneur and an Associate Professor at Duke University Medical Center with a focus in Neuromodulation and Neurorestoration.  He is Director of the Duke NeuroInnovations Program, a systematic approach to medical device innovation to large unmet clinical needs. He completed his MD and PhD in Biochemistry at Chicago Medical School and his neurosurgical residency training at Stanford with fellowships in Surgical Innovation and
Yang

Lexie Zidanyue Yang

Biostatistician II
Education: Masters Degree, Biostatistics.  Duke University School of Medicine. 2018 Overview: Lexie collaborates with doctors, residents, and fellows in the Department of Neurosurgery and Department of Pharmacy. She has strong experience in data management with large databases, such as MarketScan and HCUP. She has also worked with EHR data and CRDM. Her statistical interests include longitudinal analysis, mediation analysis, survival analysis and latent class analysis.
Alphabetical list of authors with Scholars@Duke profiles.
Open Access

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

Rights for Collection: Scholarly Articles


Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info

Make Your Work Available Here

How to Deposit

Browse

All of DukeSpaceCommunities & CollectionsAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit DateThis CollectionAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit Date

My Account

LoginRegister

Statistics

View Usage Statistics
Duke University Libraries

Contact Us

411 Chapel Drive
Durham, NC 27708
(919) 660-5870
Perkins Library Service Desk

Digital Repositories at Duke

  • Report a problem with the repositories
  • About digital repositories at Duke
  • Accessibility Policy
  • Deaccession and DMCA Takedown Policy

TwitterFacebookYouTubeFlickrInstagramBlogs

Sign Up for Our Newsletter
  • Re-use & Attribution / Privacy
  • Harmful Language Statement
  • Support the Libraries
Duke University