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Background: Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain, yet a substantial minority of implanted patients do not obtain durable relief, and patient selection still relies largely on a subjective percutaneous stimulation trial. Objective neurophysiological and psychophysical biom...
This narrative review examines current evidence through a conceptual “precision” framework organized around three axes and presents the three-axis framework as a testable hypothesis and a structure for stratified prospective trials, not as a validated clinical algorithm.
Future progress in SCS will likely depend on artificial intelligence, remote monitoring, biomarker-guided programming, and integration with multidisciplinary chronic pain care.
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