The Neuromodulation Appropriateness Consensus Committee on Best Practices for Dorsal Root Ganglion Stimulation

Timothy R. Deer, Jason E. Pope, Tim J. Lamer, Jay S. Grider, David Provenzano, Timothy R. Lubenow, James J. FitzGerald, Corey Hunter, Steven Falowski, Dawood Sayed, Ganesan Baranidharan, Nikunj K. Patel, Timothy Davis, Alex Green, Antonio Pajuelo, Lawrence J. Epstein, Michael Harned, Liong Liem, Paul J. Christo, Krishnan ChakravarthyChristopher Gilmore, Frank Huygen, Eric Lee, Pankaj Metha, Harold Nijhuis, Denis G. Patterson, Erika Petersen, Julie G. Pilitsis, Jeffery J. Rowe, Matthew P. Rupert, Ioannis Skaribas, Jennifer Sweet, Paul Verrills, Derron Wilson, Robert M. Levy, Nagy Mekhail

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Introduction: The Neuromodulation Appropriateness Consensus Committee (NACC) is dedicated to improving the safety and efficacy of neuromodulation and thus improving the lives of patients undergoing neuromodulation therapies. With continued innovations in neuromodulation comes the need for evolving reviews of best practices. Dorsal root ganglion (DRG) stimulation has significantly improved the treatment of complex regional pain syndrome (CRPS), among other conditions. Through funding and organizational leadership by the International Neuromodulation Society (INS), the NACC reconvened to develop the best practices consensus document for the selection, implantation and use of DRG stimulation for the treatment of chronic pain syndromes. Methods: The NACC performed a comprehensive literature search of articles about DRG published from 1995 through June, 2017. A total of 2538 article abstracts were then reviewed, and selected articles graded for strength of evidence based on scoring criteria established by the US Preventive Services Task Force. Graded evidence was considered along with clinical experience to create the best practices consensus and recommendations. Results: The NACC achieved consensus based on peer-reviewed literature and experience to create consensus points to improve patient selection, guide surgical methods, improve post-operative care, and make recommendations for management of patients treated with DRG stimulation. Conclusion: The NACC recommendations are intended to improve patient care in the use of this evolving therapy for chronic pain. Clinicians who choose to follow these recommendations may improve outcomes.

Original languageEnglish (US)
Pages (from-to)1-35
Number of pages35
Issue number1
StatePublished - Jan 2019


  • chronic pain
  • complex regional pain syndrome
  • dorsal root ganglion
  • spinal stimulation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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