Spinal Cord Stimulator Implantation for Post-ACDF Neuropathic Pain

Medical Necessity Assessment

The American Society of Anesthesiologists guidelines recommend spinal cord stimulation for patients with persistent radicular pain who have not responded to other therapies and for peripheral neuropathic pain 2, 3
Spinal cord stimulation is appropriate for patients who have undergone a successful trial demonstrating significant pain reduction, such as an 80% reduction in pain 1, 2
Patients who have failed conservative management, including multiple medication trials and physical therapy, are candidates for spinal cord stimulation 2
Post-surgical neuropathic pain that persists despite appropriate intervention is an established indication for spinal cord stimulation 2, 3

Significant pain reduction, such as 80% or more, during a trial period is a strong indicator of candidacy for spinal cord stimulation 2, 4, 5
Spinal cord stimulation has been shown to be effective for neuropathic pain conditions, particularly when other treatments have failed 1, 2
Symptoms such as numbness, tingling, and falls significantly impact quality of life and function, which spinal cord stimulation may improve 2

The American Diabetes Association recommends careful monitoring of glycemic control in patients with diabetes, as it may impact neuropathic symptoms 6