Spinal Cord Stimulation for Neuropathic Pain in England From 2010 to 2020: A Hospital Episode Statistics Analysis

Neuromodulation. 2023 Jan;26(1):109-114. doi: 10.1016/j.neurom.2022.02.229. Epub 2022 Apr 6.

Abstract

Objectives: Spinal cord stimulation (SCS) is a recognized intervention for the management of chronic neuropathic pain. The United Kingdom National Institute of Health and Care Excellence has recommended SCS as a management option for chronic neuropathic pain since 2008. The aim of this study is to undertake an assessment of SCS uptake across the National Health Service in England up to 2020.

Materials and methods: Hospital Episode Statistics were obtained for patients with neuropathic pain potentially eligible for SCS and patients receiving an SCS-related procedure. Data were retrieved nationally and per region from the years 2010-2011 to 2019-2020.

Results: There were 50,288 adults in England attending secondary care with neuropathic pain in 2010-2011, increasing to 66,376 in 2019-2020. The number of patients with neuropathic pain with an SCS procedure increased on a year-to-year basis until 2018-2019. However, less than 1% of people with neuropathic pain received an SCS device with no evidence of an increase over time when considering the background increase in neuropathic pain prevalence.

Conclusion: Only a small proportion of patients in England with neuropathic pain potentially eligible for SCS receives this intervention. The recommendation for routine use of SCS for management of neuropathic pain has not resulted in an uptake of SCS over the last decade.

Keywords: Cohort study; hospital episode statistics data base; intervention uptake; neuropathic pain; spinal cord stimulation.

MeSH terms

  • Adult
  • England / epidemiology
  • Humans
  • Neuralgia* / therapy
  • Spinal Cord / physiology
  • Spinal Cord Stimulation* / methods
  • State Medicine
  • Treatment Outcome
  • United Kingdom