A Cochrane for Clinicians article in the December 2023 issue of American Family Physician reviewed randomized trials assessing the effectiveness of surgically implanted spinal cord stimulation devices for the treatment of chronic low back pain . These devices come with a high price tag ($30,000) and potential complications that include electrode migration, hematoma formation, infection, spinal cord injury, and cerebrospinal fluid leak. Dr. Brian Nelson and colleagues summarized a Cochrane review of 13 placebo-controlled trials with 699 adult participants (mean age 47 to 59 years) who had low back pain for at least 12 weeks. Primary outcomes included pain intensity, physical function, and quality of life. Most studies reported outcomes at follow-up dates of one month or less; only one study reported outcomes at six months. Overall, the body of evidence was assessed as having significant bias, including selection bias (five studies), performance and detection bias (10 studies), att...