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The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for Spinal Cord Stimulation
Timothy R Deer1, Marc Russo2, Jay S Grider3
1The Spine and Nerve Center of the Virginias, Charleston, WV, USA.
Summary
The International Neuromodulation Society (INS) developed best practices for implantable neuromodulation devices. These guidelines offer recommendations for optimizing device function and managing suboptimal outcomes to improve patient care.
Area of Science:
- Neuromodulation
- Biomedical Engineering
- Neurosurgery
Background:
- The International Neuromodulation Society (INS) identified a need for best practices in optimizing implantable neuromodulation devices.
- The Neurostimulation Appropriateness Consensus Committee (NACC) was formed to provide guidance on device optimization and salvage.
- Guidance is needed for healthcare providers and individuals affected by neuromodulation devices.
Purpose of the Study:
- To establish consensus recommendations for optimizing implantable neuromodulation devices.
- To provide guidance on salvaging devices when ideal outcomes are not achieved.
- To address information gaps concerning neuromodulation device management.
Main Methods:
- Faculty nominated by the INS executive committee based on expertise and career work.
- Selection considered diversity in career paths and demographic categories.
- Faculty graded current evidence and used expert opinion to create consensus recommendations.
Main Results:
- The NACC established authoritative recommendations for the salvage and optimization of care for patients with indwelling neuromodulation devices.
- Recommendations are based on a combination of existing evidence and expert consensus.
- These guidelines are expected to evolve as new data emerge.
Conclusions:
- NACC guidance is recommended for patients experiencing less-than-optimal outcomes with implanted stimulation devices for chronic pain.
- Consideration of these consensus points may help salvage potentially failing devices before explantation.
- These recommendations aim to improve patient outcomes and device longevity.
