Description

This session explores the ongoing debate about trial vs. no trial before spinal cord stimulation (SCS) implantation. Historically mandated by NICE and NIH, trials aim to predict long-term outcomes, but recent evidence challenges their necessity. A 2022 RCT found no significant difference in pain, quality of life, or adverse events between trial and no-trial groups at 36 months, though limitations included high dropout rates and marginal statistics. Current guidelines still recommend trials—preferably percutaneous—for patient selection, reducing long-term failure and costs. Future strategies may involve AI prediction models and wireless technology to improve patient selection and streamline processes.