SCS Therapy: The Complete Guide

Part 7: SCS Candidacy Checklist

Self-Check: Could SCS Be Right for You?

Check the items that apply to you:

Basic Criteria (Common to All Types)

  • Pain has lasted for more than 3 months
  • Conservative treatment has not provided sufficient relief
  • Pain significantly affects your daily life

Type 1: No Clear Surgical Target

  • You have not yet had spinal surgery
  • You have been told that imaging does not match your symptoms
  • You have degenerative changes at multiple levels
  • You have been told "there is no clear surgical target"
  • Your pain is mainly neuropathic (numbness, radiating pain)
  • Approximately 6 months to 2 years have passed since starting conservative treatment

Type 2: Large-Scale Fusion Surgery Would Be Required

  • You have not yet had spinal surgery
  • You have been told that fusion at 2 or more levels is needed
  • You are older or have existing health conditions that make major surgery risky
  • You want to avoid the risks of prolonged hospitalization and post-surgical complications
  • Your pain is mainly neuropathic (numbness, radiating pain)

Type 3: Pain Persists After Surgery

  • You have had spinal surgery before
  • Pain continues after surgery
  • More than 3 months have passed since surgery
  • You have been told that reoperation carries high risk or uncertain benefit
  • Imaging shows improvement, yet your pain continues

Factors That Weaken the Case for SCS (All Types)

  • You have not yet tried conservative treatment sufficiently (less than 3 months)
  • There is clear nerve compression that could be resolved with a single-level surgery
  • Psychological factors are the primary cause of pain
  • Treatment for a mental health condition is needed

Exclusion Criteria

  • You currently have an active infection
  • You have a bleeding tendency (e.g., on anticoagulant medication)
  • You have severe dementia
  • You have a pacemaker (requires discussion with your doctor)

How to interpret your results:

  • All basic criteria are met + multiple items checked in any one of Types 1-3 -- SCS is worth considering
  • An exclusion criterion applies -- SCS is not feasible at this time (may be reconsidered after treatment)
  • Many weakening factors apply -- First optimize conservative treatment, or reassess the possibility of surgery