Timothy R Deer1, David A Provenzano2, Michael Hanes3, Jason E Pope4, Simon J Thomson5, Marc A Russo6, Tory McJunkin7, Michael Saulino8, Louis J Raso9, Shivanand P Lad10, Samer Narouze11, Steven M Falowski12, Robert M Levy13, Ganesan Baranidharan14, Stanley Golovac15, Didier Demesmin16, William O Witt17, Brian Simpson18, Elliot Krames19, Nagy Mekhail20. 1. Center for Pain Relief, Charleston, WV, USA. 2. Pain Diagnostics and Interventional Care, Sewickley, PA, USA. 3. Jacksonville Spine Center, Jacksonville, FL, USA. 4. Summit Pain Alliance, Santa Rosa, CA, USA. 5. Pain Management and Neuromodulation Centre, Basildon & Thurrock University Hospitals, NHS, Trust, UK. 6. Hunter Pain Clinic, Broadmeadow, NSW, Australia. 7. Pain Doctor, Inc, Phoenix, AZ, USA. 8. MossRehab, Elkins Park, PA, USA. 9. Florida Pain, Jupiter, FL, USA. 10. Division of Neurosurgery, Duke University Medical Center, Durham, NC, USA. 11. Summa Western Reserve Hospital, Cuyahoga Falls, OH, USA. 12. St. Luke's University Health Network, Bethlehem, PA, USA. 13. Marcus Neuroscience Institute, Boca Raton, FL, USA. 14. Leeds Teaching Hospital, NHS Trust, Leeds, UK. 15. Florida Pain Melbourne Clinic, Melbourne, FL, USA. 16. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 17. Cardinal Hill Pain Institute (emeritus), Lexington, KY, USA. 18. Department of Neurosurgery, University Hospital of Wales, Cardiff, UK. 19. Pacific Pain Treatment Center (ret.), San Francisco, CA, USA. 20. Cleveland Clinic, Cleveland, OH, USA.
Abstract
INTRODUCTION: The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique. METHODS: The Neurostimulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society convened an international panel of well published and diverse physicians to examine the best practices for infection mitigation and management in patients undergoing neurostimulation. The NACC recommendations are based on evidence scoring and peer-reviewed literature. Where evidence is lacking the panel added expert opinion to establish recommendations. RESULTS: The NACC has made recommendations to improve care by reducing infection and managing this complication when it occurs. These evidence-based recommendations should be considered best practices in the clinical implantation of neurostimulation devices. CONCLUSION: Adhering to established standards can improve patient care and reduce the morbidity and mortality of infectious complications in patients receiving neurostimulation.
INTRODUCTION: The use of neurostimulation for pain has been an established therapy for many decades and is a major tool in the arsenal to treat neuropathic pain syndromes. Level I evidence has recently been presented to substantiate the therapy, but this is balanced against the risk of complications of an interventional technique. METHODS: The Neurostimulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society convened an international panel of well published and diverse physicians to examine the best practices for infection mitigation and management in patients undergoing neurostimulation. The NACC recommendations are based on evidence scoring and peer-reviewed literature. Where evidence is lacking the panel added expert opinion to establish recommendations. RESULTS: The NACC has made recommendations to improve care by reducing infection and managing this complication when it occurs. These evidence-based recommendations should be considered best practices in the clinical implantation of neurostimulation devices. CONCLUSION: Adhering to established standards can improve patient care and reduce the morbidity and mortality of infectious complications in patients receiving neurostimulation.
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