Spinal Cord Stimulator Implantation for Chronic Neuropathic Pain

Patient Selection Criteria

The American College of Neurosurgery recommends spinal cord stimulation for patients with chronic neuropathic pain syndrome, such as chronic low back pain with radiation to medial thigh, who have failed conservative treatments 2
A successful SCS trial with at least 50% improvement in pain is a key requirement for permanent implantation, as seen in this patient with 80% improvement in mid-back pain during the trial period 2, 1
Patients must have a favorable psychological profile, with no evidence of untreated psychiatric comorbidity that would contraindicate implantation, and be capable of operating the device 2

Spinal cord stimulation may provide better pain control than reoperation for patients with chronic back pain with radicular symptoms 1
The North American Neuromodulation Society recognizes SCS as an effective treatment for chronic neuropathic pain when conventional pain therapies have been attempted and failed, although the exact statement is not provided here 2

Some patients may experience diminishing effectiveness of SCS over time, highlighting the need for regular follow-up to ensure optimal programming and continued efficacy 1