The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for the Mitigation of Complications of Neurostimulation

Timothy R. Deer, The Spine and Nerve Center of the Virginias, Charleston, WV, USA. Electronic address: doctdeer@aol.com.
Marc A. Russo, Hunter Pain Specialists, Newcastle, Australia.
Dawood Sayed, The University of Kansas Medical Center, Kansas City, KS, USA.
Jason E. Pope, Evolve Restorative Center, Santa Rosa, CA, USA.
Jay S. Grider, UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA.
Jonathan M. Hagedorn, Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA.
Steven M. Falowski, Neurosurgical Associates of Lancaster, Lancaster, PA, USA.
Adnan Al-Kaisy, Guy's and St. Thomas National Health Service (NHS) Foundation Trust, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
Konstantin V. Slavin, Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA; Neurology Section, Jesse Brown Veterans Administration Medical Center, Chicago, IL, USA.
Sean Li, National Spine & Pain Centers, Shrewsbury, NJ, USA.
Lawrence R. Poree, Department of Anesthesia and Perioperative Care, University of California at San Francisco, San Francisco, CA, USA.
Sam Eldabe, The James Cook University Hospital, Middlesbrough, UK.
Kaare Meier, Department of Anesthesiology (OPINord), Aarhus University Hospital, Aarhus, Arhus, Denmark; Department of Neurosurgery (Afd. NK), Aarhus University Hospital, Aarhus, Arhus, Denmark.
Tim J. Lamer, Mayo Clinic, Rochester, MN, USA.
Julie G. Pilitsis, Neurosurgery, University of Arizona, Tucson, AZ, USA.
Jose De Andrés, Valencia School of Medicine, Anesthesia Critical Care and Pain Management Department, General University Hospital, Valencia, Spain.
Christophe Perruchoud, Pain Clinic, Hôpital de La Tour, Meyrin, Switzerland.
Alexios G. Carayannopoulos, Department of Physical Medicine and Rehabilitation and Comprehensive Spine Center, Rhode Island Hospital, Providence, RI, USA; Brown University Warren Alpert Medical School (Neurosurgery), Providence, RI, USA.
Susan M. Moeschler, Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Amir Hadanny, Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
Eric Lee, Mililani Pain Center, Mililani, HI, USA.
Vishal P. Varshney, Anesthesiology and Pain Medicine, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Mehul J. Desai, International Spine, Pain & Performance Center, Virginia Hospital Center, Monument Research Institute, George Washington University School of Medicine, Arlington, VA, USA.
Peter Pahapill, Functional Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
J Osborn, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Stana Bojanic, Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Ajay Antony, The Orthopaedic Institute, Gainesville, FL, USA.
Fabian Piedimonte, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.
Salim M. Hayek, Case Western Reserve University, University Hospitals of Cleveland, Cleveland, OH, USA.
Robert M. Levy, Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA.

Document Type

Journal Article

Publication Date

6-13-2024

Journal

Neuromodulation : journal of the International Neuromodulation Society

DOI

10.1016/j.neurom.2024.04.004

Keywords

Best practices; consensus; neuromodulation; neurostimulation; spinal cord stimulation

Abstract

INTRODUCTION: The International Neuromodulation Society convened a multispecialty group of physicians based on expertise and international representation to establish evidence-based guidance on the mitigation of neuromodulation complications. This Neurostimulation Appropriateness Consensus Committee (NACC)® project intends to update evidence-based guidance and offer expert opinion that will improve efficacy and safety. MATERIALS AND METHODS: Authors were chosen on the basis of their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches of MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar, and PubMed from 2017 (when NACC last published guidelines) to October 2023. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on the strength of evidence or consensus when evidence was scant. RESULTS: The NACC examined the published literature and established evidence- and consensus-based recommendations to guide best practices. Additional guidance will occur as new evidence is developed in future iterations of this process. CONCLUSIONS: The NACC recommends best practices regarding the mitigation of complications associated with neurostimulation to improve safety and efficacy. The evidence- and consensus-based recommendations should be used as a guide to assist decision-making when clinically appropriate.

Department

Anesthesiology and Critical Care Medicine

Link to Full Text

Share

COinS