{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:55:59Z","timestamp":1777964159593,"version":"3.51.4"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Pain Headache Rep"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to review the societal, economic, and racial factors that impact the usage of spinal cord stimulation for chronic pain. Our working hypothesis is that patients of ethnic minority groups or of lower socioeconomic status (SES) status may have lower implantation rates and usage of spinal cord stimulation (SCS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Our study sourced publications from PubMed, Embase, and Cochrane Library on December 21st, 2023 for SCS for the purposes of pain management. Articles were excluded from the review if the study was not USA based, did not involve SCS for the purpose of pain or did not allow for the subgroup analysis. There were 1028 reports that resulted after the initial search with 184 duplicates which were removed. Six reports met the inclusion and exclusionary criteria and were included in the review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Several trends were able to be extrapolated from the pooled reviews. Orhurhu et al. found that Black and Hispanic minorities had a higher utilization rate of SCSs than their White and Asian counterparts in the inpatient setting. Jones and Missios et al. found that in the outpatient setting, White and privately insured patients were more likely to utilize SCS. Ovrom et al. observed an increased cost associated with Hispanic ethnicity and inpatient SCS utilization. Wondwossen et al. found that in the US military system White patients were more likely to receive SCS earlier in their care than Black patients. Labaran et al. concluded the Southern US completed more SCS implants, particularly in White patients with Medicare insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>White patients are recipients of SCS earlier and more frequently than minority patients in the outpatient setting. There is mixed evidence regarding inpatient SCS and how household income relates to SCS usage. Insurance type and coverage may be more accurately predictive than simple household income for SCS utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11916-024-01315-6","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T09:08:48Z","timestamp":1738228128000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Racial and Low Socioeconomic Status on the Implementation of Spinal Cord Stimulation for Chronic Pain in the United States"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7039-8124","authenticated-orcid":false,"given":"Gabriel","family":"Howard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Guinand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Kervyn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behnum","family":"Habibi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"issue":"19","key":"1315_CR1","doi-asserted-by":"publisher","first-page":"2579","DOI":"10.1001\/jama.283.19.2579","volume":"283","author":"K Fiscella","year":"2000","unstructured":"Fiscella K, Franks P, Gold MR, Clancy CM. Inequality in quality. JAMA. 2000;283(19):2579. https:\/\/doi.org\/10.1001\/jama.283.19.2579.","journal-title":"JAMA"},{"issue":"1S1","key":"1315_CR2","doi-asserted-by":"publisher","first-page":"S86","DOI":"10.1016\/j.amepre.2016.09.024","volume":"52","author":"I Stepanikova","year":"2017","unstructured":"Stepanikova I, Oates GR. Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race. Am J Prev Med. 2017;52(1S1):S86\u201394. https:\/\/doi.org\/10.1016\/j.amepre.2016.09.024.","journal-title":"Am J Prev Med"},{"issue":"12","key":"1315_CR3","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1016\/j.jpain.2017.07.005","volume":"18","author":"MR Janevic","year":"2017","unstructured":"Janevic MR, McLaughlin SJ, Heapy AA, Thacker C, Piette JD. Racial and socioeconomic disparities in disabling chronic pain: Findings from the Health and Retirement Study. J Pain. 2017;18(12):1459\u201367. https:\/\/doi.org\/10.1016\/j.jpain.2017.07.005.","journal-title":"J Pain"},{"issue":"36","key":"1315_CR4","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","volume":"67","author":"J Dahlhamer","year":"2018","unstructured":"Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact chronic pain among adults \u2014 United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(36):1001\u20136. https:\/\/doi.org\/10.15585\/mmwr.mm6736a2.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5","key":"1315_CR5","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/ner.12101","volume":"17","author":"S Missios","year":"2014","unstructured":"Missios S, Rahmani R, Bekelis K. Spinal cord stimulators: Socioeconomic disparities in four US states. Neuromodulation: Technol Neural Interface. 2014;17(5):451\u20136. https:\/\/doi.org\/10.1111\/ner.12101.","journal-title":"Neuromodulation: Technol Neural Interface"},{"key":"1315_CR6","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.jocn.2022.02.019","volume":"98","author":"E Ovrom","year":"2022","unstructured":"Ovrom E, Hagedorn JM, Bhandarkar A, Bydon M. Racial disparities in the cost of inpatient spinal cord stimulator surgery among patients in the 2016\u20132018 National Inpatient Sample. J Clin Neurosci. 2022;98:189\u201393. https:\/\/doi.org\/10.1016\/j.jocn.2022.02.019.","journal-title":"J Clin Neurosci"},{"issue":"Suppl 14","key":"1315_CR7","doi-asserted-by":"publisher","first-page":"S53","DOI":"10.1097\/BRS.0000000000002179","volume":"42","author":"R Vallejo","year":"2017","unstructured":"Vallejo R, Bradley K, Kapural L. Spinal cord stimulation in chronic pain: mode of action. Spine\u00a0(Phila Pa 1976). 2017;42(Suppl 14):S53\u201360. https:\/\/doi.org\/10.1097\/BRS.0000000000002179.","journal-title":"Spine\u00a0(Phila Pa 1976)"},{"issue":"3","key":"1315_CR8","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1111\/ner.13373","volume":"24","author":"MR Jones","year":"2021","unstructured":"Jones MR, Orhurhu V, O\u2019Gara B, et al. Racial and socioeconomic disparities in spinal cord stimulation among the Medicare population. Neuromodulation: Technol Neural Interface. 2021;24(3):434\u201340. https:\/\/doi.org\/10.1111\/ner.13373.","journal-title":"Neuromodulation: Technol Neural Interface"},{"key":"1315_CR9","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s42234-019-0023-1","volume":"5","author":"J Caylor","year":"2019","unstructured":"Caylor J, Reddy R, Yin S, Cui C, Huang M, Huang C, Ramesh R, Baker DG, Simmons A, Souza D, Narouze S, Vallejo R, Lerman I. 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Pain Pract. 2020;21(1):75\u201382. https:\/\/doi.org\/10.1111\/papr.12936.","journal-title":"Pain Pract"},{"issue":"5","key":"1315_CR12","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.neurom.2023.03.008","volume":"27","author":"Y Wondwossen","year":"2024","unstructured":"Wondwossen Y, Patzkowski MS, Amoako MY, Lawson BK, Velosky AG, Soto AT, Highland KB. Spinal Cord Stimulator Inequities Within the US Military Health System. Neuromodulation. 2024;27(5):916\u201322. https:\/\/doi.org\/10.1016\/j.neurom.2023.03.008.","journal-title":"Neuromodulation"},{"issue":"2","key":"1315_CR13","doi-asserted-by":"publisher","first-page":"384","DOI":"10.14245\/ns.1938276.138","volume":"17","author":"L Labaran","year":"2020","unstructured":"Labaran L, Bell J, Puvanesarajah V, et al. Demographic trends in paddle lead spinal cord stimulator placement: Private Insurance and Medicare beneficiaries. 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