Survey of the practice of spinal cord stimulators and intrathecal analgesic delivery implants for management of pain in Canada.
BACKGROUND
In 2006, the Canadian Neuromodulation Society was formed. The present survey characterizes the practice of spinal cord stimulator (SCS) and intrathecal analgesic delivery pump (IADP) implantation for pain management in different centres across Canada.


METHODS
A structured questionnaire was designed to examine the funding source, infrastructure and patient screening process in different centres implanting SCSs and IADPs. Centres that performed more than 10 implants per year were surveyed. The survey was centre-based, ie, each centre received one questionnaire regardless of the number of staff involved in neuromodulation practice.


RESULTS
Fourteen centres were identified and 13 responded. Implantation of SCS and IADP was performed in 12 and 10 centres, respectively. In most centres, failed back surgery syndrome was the most frequent indication for SCS and IADP implantation. For SCS, all centres always performed a trial; the majority used percutaneous electrode (83%) before the SCS implantation. Routine psychological screening was performed in 25% of centres before any SCS trial procedure. For IADP, all centres performed a trial injection or infusion before implantation. Five centres (50%) performed psychological screening in almost all patients. Continuous infusion techniques were the most popular (50%) used for the trial.


CONCLUSIONS
The present survey provides a 'snapshot' of the practice of SCS and IADP implantation in Canada. A review of SCS and IADP trials indicated that Canadian practices are mostly, but not always, consistent with those elsewhere.
Peng
Philip W H
PW
Department of Anesthesiology and Pain Management, Toronto Western Division, University Health Network, University of Toronto, Toronto, Ontario, Canada. philip.peng@uhn.on.ca
Fedoroff
Ingrid
I
Jacques
Line
L
Kumar
Krishna
K
D000698:Analgesia / Q000706:statistics & numerical data*; D000700:Analgesics / Q000008:administration & dosage; D002170:Canada; D004599:Electric Stimulation Therapy / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000706:statistics & numerical data*; D007278:Injections, Spinal; D010146:Pain / Q000188:drug therapy*; D018710:Pain Clinics / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data; D013116:Spinal Cord; D011795:Surveys and Questionnaires
D000700:Analgesics