title: State of the field survey: spinal cord stimulator use by academic pain medicine practices.
abstract: OBJECTIVE
  The concept of neuromodulation via the use of spinal cord stimulators (SCS) was first established over forty years ago. Since then, its popularity has grown as numerous studies have demonstrated its utility to reduce chronic pain, improve patient function, and reduce long-term health care costs. The aim of this study was to update the pain medicine community on the evolution of SCS practice trends in academic centers.
  
  
  METHODS
  Ninety-three pain medicine fellowship programs in the United States were identified from the Accreditation Council for Graduate Medical Education Website and were contacted to participate in an internet survey. A 37-item questionnaire was inspired by a previous study performed by Fanciullo et al. Questions focused on three main themes regarding SCS clinical application, namely demographics, education, and technical matters.
  
  
  RESULTS
  Completed surveys were received from 50 institutions, all of which reported performing SCS interventions. Annual implants ranged from 0 to 150. Fellowship training was cited as the most valuable modality for learning implantation. Nearly all programs reported manufacturer representative participation during SCS procedures, with a minority of program directors discouraging their involvement in fellow education. SCS trials were performed exclusively on an outpatient basis. The average length for trials was 4-7 days. The most common indication for SCS implantation was failed back surgery syndrome, which also had the highest 2-year success rate. Post procedure, patients generally were followed up every 2-4 weeks for device reprogramming, which was performed by company representatives 92% of the time.
  
  
  CONCLUSIONS
  Standardized SCS training is imperative as the implementation of neuromodulation therapy continues to increase.
authors.affiliation: Department of Anesthesiology, Pain Management, New York University Langone Medical Center, New York, New York, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Gharibo
authors.forename: Gary
authors.initials: G
authors.lastname: Laux
authors.forename: Brian R
authors.initials: BR
authors.lastname: Forzani
authors.forename: Christopher
authors.initials: C
authors.lastname: Sellars
authors.forename: Eric
authors.initials: E
authors.lastname: Kim
authors.forename: Shengping
authors.initials: S
authors.lastname: Zou
mesh_terms: D003625:Data Collection; D004503:Education, Medical, Graduate / Q000592:standards / Q000639:trends; D005257:Fellowships and Scholarships; D006801:Humans; D059408:Pain Management / Q000379:methods*; D062187:Spinal Cord Stimulation / Q000592:standards* / Q000706:statistics & numerical data* / Q000639:trends*
keywords: Neuromodulation; Pain Fellowship; Spinal Cord Stimulation; Survey