经皮引线脊髓刺激器植入的人口统计学趋势：私人保险和医疗保险受益人。
Demographic Trends in Paddle Lead Spinal Cord Stimulator Placement: Private Insurance and Medicare Beneficiaries.
作者信息
Labaran Lawal, Bell Joshua, Puvanesarajah Varun, Jain Nikhil, Aryee Jomar N, Raad Micheal, Jain Amit, Carmouche Jonathan, Hassanzadeh Hamid
机构信息
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA.
Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
出版信息
Neurospine. 2020 Jun;17(2):384-389. doi: 10.14245/ns.1938276.138. Epub 2020 Feb 1.
OBJECTIVE
Although spinal cord stimulators (SCS) continue to gain acceptance as a viable nonpharmacologic option for the treatment of chronic back pain, recent trends are not well established. The aim of this study was to evaluate recent overall demographic and regional trends in paddle lead SCS placement and to determine if differences in trends exist between private-payer and Medicare beneficiaries.
METHODS
A retrospective review of Medicare and private-payer insurance records from 2007-2014 was performed to identify patients who underwent a primary paddle lead SCS placement via a laminectomy (CPT-63655). Each study cohort was queried to determine the annual rate of SCS placements and demographic characteristics. Yearly SCS implantation rates within the study cohorts were adjusted per 100,000 beneficiaries. A chi-square analysis was used to compare changes in annual rates.
RESULTS
A total of 31,352 Medicare and 2,935 private-payer patients were identified from 2007 to 2014. Paddle lead SCS placements ranged from 5.9 to 17.5 (p<0.001), 1.9 to 5.9 (p<0.001), and 5.2 to 14.5 (p<0.001) placements per 100,000 Medicare, private-payer, and overall beneficiaries respectively from 2007 to 2014. SCS placements peaked in 2013 with 19.6, 7.1, and 16.8 placements per 100,000 Medicare, private-payer, and overall patients.
CONCLUSION
There was an overall increase in the annual rate of SCS placements from 2007 to 2014. Paddle lead SCS placements peaked in 2013 for Medicare, private-payer, and overall beneficiaries. The highest incidence of implantation was in the Southern region of the United States and among females. Yearly adjusted rates of SCSs were higher among Medicare patients at all time points.
目的
尽管脊髓刺激器（SCS）作为治疗慢性背痛的一种可行的非药物选择，其认可度持续上升，但近期趋势尚不明确。本研究的目的是评估近期经皮穿刺电极SCS植入的总体人口统计学和地区趋势，并确定私人付费者和医疗保险受益人的趋势是否存在差异。
方法
对2007年至2014年医疗保险和私人付费保险记录进行回顾性分析，以确定通过椎板切除术（CPT-63655）进行初次经皮穿刺电极SCS植入的患者。对每个研究队列进行查询，以确定SCS植入的年发生率和人口统计学特征。研究队列中的年度SCS植入率按每10万名受益人进行调整。采用卡方分析比较年发生率的变化。
结果
2007年至2014年共确定31352名医疗保险患者和2935名私人付费患者。2007年至2014年，每10万名医疗保险、私人付费和总体受益人中，经皮穿刺电极SCS植入率分别为5.9至17.5（p<0.001）、1.9至5.9（p<0.001）和5.2至14.5（p<0.001）。SCS植入在2013年达到峰值，每10万名医疗保险、私人付费和总体患者中的植入率分别为19.6、7.1和16.8。
结论
2007年至2014年SCS植入的年发生率总体呈上升趋势。经皮穿刺电极SCS植入在2013年达到峰值，涉及医疗保险、私人付费和总体受益人。植入发生率最高的是美国南部地区和女性。所有时间点医疗保险患者的年度SCS调整率均较高。
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