Authors' objectives: The principal objectives of the re-assessment of spinal cord stimulators were to determine the level of evidence of the studies available and to define the criteria for assessing efficacy and safety with a view to specifying their indications in the context of those already being reimbursed. The project also aimed to specify the role of these devices in the therapeutic strategy and to estimate the target population in each indication. The conditions of realisation and the technical environment were also specified. The working method used was based on a systematic review of the literature, analysis of the data provided by the manufacturers, and recourse to the expertise of healthcare professionals meeting in a multidisciplinary working group dedicated to the subject. The experts approached declared any potential conflict of interest at the start of and throughout the project. Also, three neurosurgeons with particular expertise in the area of spinal cord stimulation were identified but did not participate in the working group because of their conflicts of interest. For this reason they were questioned individually by responding to a preestablished questionnaire.

Authors' recommendations: In view of the suggestions of the working group and of the healthcare professionals questioned, CNEDiMTS considers that spinal cord stimulation has a role in the treatment of chronic pain with the following characteristics: ► chronic pain of neuropathic origin, after the failure of therapeutic alternatives, secondary to: - radicular or axial pain syndrome of diabetic, post-herpetic, traumatic or surgical origin persisting for at least one year; - complex regional pain syndrome types I and II persisting for at least 6 months. ► chronic pain of ischaemic origin, after the failure of therapeutic alternatives, secondary to Buerger's disease.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.has-sante.fr/portail/upload/docs/application/pdf/2014-03/rapport_neurostimulateurs.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr