Psychological selection criteria for implantable spinal cord stimulators

Nearly three decades of spinal cord stimulation (SCS) as a treatment for chronic pain have seen a waxing and waning of enthusiasm for SCS but, more recently, an expanding role of SCS in contemporary chronic pain management. Increased refinement of patient selection criteria has been an important focus to improve SCS outcomes. This article reviews the history of psychological selection criteria in SCS implantation, assesses the data to support their utility, and offers a conceptualization for the incorporation of psychological factors in determining suitability for SCS implantation. When conceptualized properly within a multidisciplinary rehabilitation process, the clinical judgments and assessment procedures of experienced psychological practitioners have played, and should continue to play, a role in the evaluation for, and treatment with SCS.