DBS of the SCC for the Treatment of Medically Refractory CLBP

Inclusion Criteria: * Pain secondary to failed back surgery syndrome (FBSS) as defined by persistent low back pain despite prior surgical interventions. * Self-reported average back pain intensity of greater than 8 out of 10 on the Visual Analog Scale (VAS) documented over greater than 2 years. * Failure to achieve at least 50% pain relief from a trial of spinal cord stimulation (SCS) or less than 50% pain relief after 3 months of SCS therapy or patient refuses/rejects SCS trial * Failure to achieve at least 50% pain relief in response to at least 4 weeks of physical therapy. * Failure to achieve at least 50% pain relief in response to at least 2 percutaneous spinal pain procedures. * Failure to achieve at least 50% pain relief in response to 3 months of opioid therapy (at least 20 MEQ/day) or inability to increase or tolerate opioid therapy due to dose-limiting side effects). * Failure to achieve at least 50% pain relief in response to a 3-month trial of at least one other class of pain medication in addition to opioid therapy or inability to tolerate increasing doses of non-opioid pain medications due to dose-limiting side effects. * Lack of a surgically correctible etiology for the pain as determined by 2 independent neurosurgeons * Age greater than 40 years of age. * Ability to give informed consent in accordance with institutional policies and participate in the 1.5-year follow-up, involving assessments and stimulator adjustments. * Willingness to share unexpected neurological or psychiatric symptoms with study clinicians. Exclusion Criteria: * Significant neurocognitive impairment (MoCA \< 26). * Age \> 75 years. * History of implant-related infection. * History of bleeding disorder or immune-compromise. * Psychiatric comorbidity other than depression or generalized anxiety disorder, as determined by MINI International Neuropsychiatric Interview. * Patients with neurological diagnoses that may reduce the response to or increase the risk of DBS including neurodegenerative conditions, severe movement disorders, demyelinating disorders, syringomyelia, epilepsy or history of seizures, history of CNS tumors (spinal and/or cranial), history of serious head injury with loss of consciousness, history of stroke, surgically reversible peripheral pain syndromes including surgically correctable radiculopathy, and severe peripheral neuropathy. * Patients who have undergone spine surgery within the previous 3 months. * Major medical co-morbidities increasing the r…