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March 5, 2026Pain and TherapyOpen Access

Objective, Same-Day SCS Trials with ECAP-Controlled Closed-Loop Therapy: Depth of Response is Maintained from Trial to 12 months

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Why the study?

Does a same-day trial of ECAP-controlled closed-loop spinal cord stimulation maintain long-term pain relief and functional improvement in patients with chronic intractable pain?

Population

15 patients with chronic, intractable trunk and/or limb pain who underwent a day 0 trial using…

Design

Cohort

Follow-up

12 months

Key result

ECAP-controlled closed-loop SCS day 0 trials with same-day lead removal achieved sustained mean pain reduction of 79.6% at 12 months with 81.8% of patients maintaining ≥50% reduction.

Authors

JPJason E. PopeCVChau VuJGJohnathan Goree

Discussion

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Member takes

Overview

Enables single-day SCS procedures in practice; extends evidence for ECAP-controlled closed-loop efficacy.

Key Points

  • To evaluate the durability of the response to SCS (Spinal Cord Stimulation) therapy over 12 months after same-day trials.
  • Conducted same-day trials involving SCS therapy
  • Utilized ECAP (Electrocutaneous Action Potential) controlled mechanisms
  • Followed subjects for a duration of 12 months
  • Response depth remained consistent from trial to follow-up at 12 months
  • Demonstrated sustained effectiveness of the therapy
  • Indicated potential for reliable long-term pain management

Structured PICO

Does a same-day trial of ECAP-controlled closed-loop spinal cord stimulation maintain long-term pain relief and functional improvement in patients with chronic intractable pain?

P
Population
15 patients with chronic, intractable trunk and/or limb pain who underwent a day 0 trial using ECAP-controlled closed-loop spinal cord stimulation at a single center in the ECAP Study. Mean age 65.3 years, 60% female.
I
Intervention
Same-day (day 0) trial of ECAP-controlled closed-loop spinal cord stimulation (CL-SCS) followed by permanent implantation
O
Outcome
Patient-reported outcomes including Visual Analogue Scale (VAS) percent reduction, Pain Impact Score (PIS), responder rates, and neural metrics at day 0, 3 months, and 12 monthspatient reported

Main Result

Effect estimate: Mean VAS percent reduction 85.5% at day 0, 79.6% at 12 months

p-value: p=<0.001 for change from baseline at all visits

Same-day trials of ECAP-controlled closed-loop spinal cord stimulation provide durable pain relief and functional improvement up to 12 months, suggesting prolonged multi-day trials may not be necessary for all patients.

Limitations

  • Small sample size (n=15) and single-center design limits generalizability
  • Cohort consisted exclusively of day 0 responders, possibly biasing outcomes
  • Patients required insurance coverage that did not mandate trial duration, introducing selection bias
  • Only one SCS system brand used, limiting applicability to other systems
  • Single-center analysis
  • Small sample size
  • Lack of randomization or control group

Cite This Study

Pope et al. (2026) studied Adults with chronic, intractable trunk and/or limb pain undergoing ECAP-controlled closed-loop spinal cord stimulation day 0 trial (n=15). ECAP-controlled closed-loop spinal cord stimulation (CL-SCS) vs. None (single-arm observational cohort) was evaluated on Pain reduction measured by Visual Analogue Scale (VAS) percent reduction and responder rates (≥50%), sustained through 12 months (Mean VAS percent reduction 85.5% at day 0, 79.6% at 12 months, p=<0.001 for change from baseline at all visits). ECAP-controlled closed-loop SCS day 0 trials with same-day lead removal achieved sustained mean pain reduction of 79.6% at 12 months with 81.8% of patients maintaining ≥50% reduction.

synapsesocial.com/papers/69a91e1fd6127c7a504c1c81https://doi.org/10.1007/s40122-026-00821-2
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