TY - JOUR
T1 - The appropriate use of neurostimulation of the spinal cord and peripheral nervous system for the treatment of chronic pain and ischemic diseases
T2 - The neuromodulation appropriateness consensus committee
AU - Deer, Timothy R.
AU - Mekhail, Nagy
AU - Provenzano, David
AU - Pope, Jason
AU - Krames, Elliot
AU - Leong, Michael
AU - Levy, Robert M.
AU - Abejon, David
AU - Buchser, Eric
AU - Burton, Allen
AU - Buvanendran, Asokumar
AU - Candido, Kenneth
AU - Caraway, David
AU - Cousins, Michael
AU - Dejongste, Michael
AU - Diwan, Sudhir
AU - Eldabe, Sam
AU - Gatzinsky, Kliment
AU - Foreman, Robert D.
AU - Hayek, Salim
AU - Kim, Philip
AU - Kinfe, Thomas
AU - Kloth, David
AU - Kumar, Krishna
AU - Rizvi, Syed
AU - Lad, Shivanand P.
AU - Liem, Liong
AU - Linderoth, Bengt
AU - Mackey, Sean
AU - McDowell, Gladstone
AU - McRoberts, Porter
AU - Poree, Lawrence
AU - Prager, Joshua
AU - Raso, Lou
AU - Rauck, Richard
AU - Russo, Marc
AU - Simpson, Brian
AU - Slavin, Konstantin
AU - Staats, Peter
AU - Stanton-Hicks, Michael
AU - Verrills, Paul
AU - Wellington, Joshua
AU - Williams, Kayode
AU - North, Richard
PY - 2014/8
Y1 - 2014/8
N2 - Introduction The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended appropriate clinical applications. Methods The NACC used literature reviews, expert opinion, clinical experience, and individual research. Authors consulted the Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Neuropathic Pain (2006), systematic reviews (1984 to 2013), and prospective and randomized controlled trials (2005 to 2013) identified through PubMed, EMBASE, and Google Scholar. Results Neurostimulation is relatively safe because of its minimally invasive and reversible characteristics. Comparison with medical management is difficult, as patients considered for neurostimulation have failed conservative management. Unlike alternative therapies, neurostimulation is not associated with medication-related side effects and has enduring effect. Device-related complications are not uncommon; however, the incidence is becoming less frequent as technology progresses and surgical skills improve. Randomized controlled studies support the efficacy of spinal cord stimulation in treating failed back surgery syndrome and complex regional pain syndrome. Similar studies of neurostimulation for peripheral neuropathic pain, postamputation pain, postherpetic neuralgia, and other causes of nerve injury are needed. International guidelines recommend spinal cord stimulation to treat refractory angina; other indications, such as congestive heart failure, are being investigated. Conclusions Appropriate neurostimulation is safe and effective in some chronic pain conditions. Technological refinements and clinical evidence will continue to expand its use. The NACC seeks to facilitate the efficacy and safety of neurostimulation.
AB - Introduction The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended appropriate clinical applications. Methods The NACC used literature reviews, expert opinion, clinical experience, and individual research. Authors consulted the Practice Parameters for the Use of Spinal Cord Stimulation in the Treatment of Neuropathic Pain (2006), systematic reviews (1984 to 2013), and prospective and randomized controlled trials (2005 to 2013) identified through PubMed, EMBASE, and Google Scholar. Results Neurostimulation is relatively safe because of its minimally invasive and reversible characteristics. Comparison with medical management is difficult, as patients considered for neurostimulation have failed conservative management. Unlike alternative therapies, neurostimulation is not associated with medication-related side effects and has enduring effect. Device-related complications are not uncommon; however, the incidence is becoming less frequent as technology progresses and surgical skills improve. Randomized controlled studies support the efficacy of spinal cord stimulation in treating failed back surgery syndrome and complex regional pain syndrome. Similar studies of neurostimulation for peripheral neuropathic pain, postamputation pain, postherpetic neuralgia, and other causes of nerve injury are needed. International guidelines recommend spinal cord stimulation to treat refractory angina; other indications, such as congestive heart failure, are being investigated. Conclusions Appropriate neurostimulation is safe and effective in some chronic pain conditions. Technological refinements and clinical evidence will continue to expand its use. The NACC seeks to facilitate the efficacy and safety of neurostimulation.
KW - Angina pectoris
KW - Reynaud's syndrome
KW - chronic pain
KW - complex regional pain syndrome
KW - failed back surgery syndrome
KW - high-frequency electrical stimulation
KW - ischemic pain
KW - neuropathic pain
KW - nociceptive pain
KW - phantom limb pain
KW - postherpetic neuralgia
KW - spinal cord stimulation
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U2 - 10.1111/ner.12208
DO - 10.1111/ner.12208
M3 - Review article
C2 - 25112889
AN - SCOPUS:84905973343
SN - 1094-7159
VL - 17
SP - 515
EP - 550
JO - Neuromodulation
JF - Neuromodulation
IS - 6
ER -