Papers of the Week

Current research indicates that spinal cord stimulation (SCS) has a positive short-term impact on outcomes such as quality of life, pain, and productivity in patients with chronic neuropathic pain. However, there is a need for studies on larger population samples. This study utilized data from Swedish national registers to analyze change and predictors of sick leave and disability pension two years before and after SCS treatment. Patients with SCS implanted between 2006-2017, and a reference group consisting of 5 individuals matched to each SCS patient without replacement with respect to age, sex, and region of residence, were included. A difference-in-difference approach was used to compare the average change (two years after treatment versus two years before treatment) in net disability days and indirect cost related to disability days for the SCS group, compared to the average change for the reference group. The results showed that SCS treatment in Sweden is associated with a decrease of 21 disability days and consequent decrease in indirect cost of €3,372 in working age patients. Large work loss prior to index date was also demonstrated (average 214 days one year prior), indicating a significant burden on the patient, employers, and the society at large. The number of disability days varied considerably depending on age, sex, socioeconomic variables, and comorbidities, however, the effect of SCS appeared to have little association with patient characteristics. This economic benefit needs to be considered, as well as the clinical outcome, when evaluating the full societal value of SCS.