Timothy R Deer1, Tim J Lamer2, Jason E Pope3, Steven M Falowski4, David A Provenzano5, Konstantin Slavin6, Stanley Golovac7, Jeffrey Arle8, Joshua M Rosenow9, Kayode Williams10, Porter McRoberts11, Samer Narouze12, Sam Eldabe13, Shivanand P Lad14, Jose A De Andrés15, Eric Buchser16, Philippe Rigoard17, Robert M Levy18, Brian Simpson19, Nagy Mekhail20. 1. Center for Pain Relief, Charleston, WV, USA. 2. Mayo Clinic, Rochester, MN, USA. 3. Summit Pain Alliance, Santa Rosa, CA, USA. 4. St. Luke's University Health Network, Bethlehem, PA, USA. 5. Pain Diagnostics and Interventional Care, Sewickley, PA, USA. 6. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA. 7. Florida Pain Melbourne Clinic, Melbourne, FL, USA. 8. Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA, USA. 9. Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 10. Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. 11. Holy Cross Hospital, Ft. Lauderdale, FL, USA. 12. Summa Western Reserve Hospital, Cuyahoga Falls, OH, USA. 13. The James Cook University Hospital, Middlesbrough, UK. 14. Division of Neurosurgery, Duke University Medical Center, Durham, NC, USA. 15. Valencia School of Medicine, Hospital General Universitario, Valencia, Spain. 16. Anaesthesia and Pain Management Department, EHC Hosptial, Morges, and CHUV University Hospital, Lausanne, Switzerland. 17. Service de Neurochirurgie, CHU de Poitiers, France. 18. Marcus Neuroscience Institute, Boca Raton, FL, USA. 19. Department of Neurosurgery, University Hospital of Wales, Cardiff, UK. 20. Cleveland Clinic, Cleveland, OH, USA.
Abstract
INTRODUCTION: Neurostimulation involves the implantation of devices to stimulate the brain, spinal cord, or peripheral or cranial nerves for the purpose of modulating the neural activity of the targeted structures to achieve specific therapeutic effects. Surgical placement of neurostimulation devices is associated with risks of neurologic injury, as well as possible sequelae from the local or systemic effects of the intervention. The goal of the Neurostimulation Appropriateness Consensus Committee (NACC) is to improve the safety of neurostimulation. METHODS: The International Neuromodulation Society (INS) is dedicated to improving neurostimulation efficacy and patient safety. Over the past two decades the INS has established a process to use best evidence to improve care. This article updates work published by the NACC in 2014. NACC authors were chosen based on nomination to the INS executive board and were selected based on publications, academic acumen, international impact, and diversity. In areas in which evidence was lacking, the NACC used expert opinion to reach consensus. RESULTS: The INS has developed recommendations that when properly utilized should improve patient safety and reduce the risk of injury and associated complications with implantable devices. CONCLUSIONS: On behalf of INS, the NACC has published recommendations intended to reduce the risk of neurological injuries and complications while implanting stimulators.
INTRODUCTION: Neurostimulation involves the implantation of devices to stimulate the brain, spinal cord, or peripheral or cranial nerves for the purpose of modulating the neural activity of the targeted structures to achieve specific therapeutic effects. Surgical placement of neurostimulation devices is associated with risks of neurologic injury, as well as possible sequelae from the local or systemic effects of the intervention. The goal of the Neurostimulation Appropriateness Consensus Committee (NACC) is to improve the safety of neurostimulation. METHODS: The International Neuromodulation Society (INS) is dedicated to improving neurostimulation efficacy and patient safety. Over the past two decades the INS has established a process to use best evidence to improve care. This article updates work published by the NACC in 2014. NACC authors were chosen based on nomination to the INS executive board and were selected based on publications, academic acumen, international impact, and diversity. In areas in which evidence was lacking, the NACC used expert opinion to reach consensus. RESULTS: The INS has developed recommendations that when properly utilized should improve patient safety and reduce the risk of injury and associated complications with implantable devices. CONCLUSIONS: On behalf of INS, the NACC has published recommendations intended to reduce the risk of neurological injuries and complications while implanting stimulators.
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Authors: Timothy Deer; Jason Pope; Corey Hunter; Steven Falowski; Leonardo Kapural; Jeffery Kramer; Robert Levy Journal: Neuromodulation Date: 2019-03-12
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