Dr. Sean Li introduces the ECAP controlled closed-loop spinal cord stimulation (SCS), a recently FDA-approved medical device. He highlights the history of patients' dissatisfaction with SDS and the importance of providing tailored care through titration of electricity, similar to the administering of drugs. Dr. Li explains the theory behind neural activation and the differences between closed-loop and open-loop systems of neuromodulation. He presents compelling clinical evidence in favor of the ECAP controlled closed-loop SCS.

In this thought-provoking talk, the speaker explores the overwhelming complexity and rapid innovation in spinal cord stimulation (SCS) — particularly the explosion of waveform options. Rather than focusing on waveform mechanics, they question whether more choices actually benefit patients or simply burden clinicians, patients, and health systems with analysis paralysis and inefficiencies. With the pace of innovation outpacing hospital adoption and payer confidence, the speaker calls for a shift toward streamlined, software-driven solutions that offer flexibility and cost-effectiveness without excessive hardware variation. The presentation challenges the field to balance innovation with clarity, access, and long-term value.

Dr. Ashish Shetty presents the potential of neuromodulation as a treatment option for pelvic pain. Dr. Shetty presents a case report of a 54-year-old woman who received a retrograde/antegrade lead implanted in her sacrum and reported >80% pain relief at a three-month follow-up and 95% pain relief at up to 36 months. Dr. Shetty describes the various neuromodulation modalities being implemented at University College London Hospitals (UCLH) and discusses their evidence base, experiences, and limitations of neuromodulation.

Dr. Tony L. Yaksh presents his thoughts on the future of neuraxial drug delivery. He starts by discussing the history of spinal therapeutics and the development of neuraxial drug delivery in the 1900s. Dr. Yaksh explains the need for drugs to be delivered to the spine. He discusses neuraxial drug targets, specifying the dorsal root ganglion as a significant drug target. He also discusses intrathecal delivery platforms, delivery protocols and systems., as well as the future implementation of neuraxial drugs.