Deer Timothy R, Pope Jason E, Lamer Tim J, Grider Jay S, Provenzano David, Lubenow Timothy R, FitzGerald James J, Hunter Corey, Falowski Steven, Sayed Dawood, Baranidharan Ganesan, Patel Nikunj K, Davis Timothy, Green Alex, Pajuelo Antonio, Epstein Lawrence J, Harned Michael, Liem Liong, Christo Paul J, Chakravarthy Krishnan, Gilmore Christopher, Huygen Frank, Lee Eric, Metha Pankaj, Nijhuis Harold, Patterson Denis G, Petersen Erika, Pilitsis Julie G, Rowe Jeffery J, Rupert Matthew P, Skaribas Ioannis, Sweet Jennifer, Verrills Paul, Wilson Derron, Levy Robert M, Mekhail Nagy
Center for Pain Relief, Charleston, WV, USA.
Evolve Restorative Center, Santa Rosa, CA, USA.
Neuromodulation. 2019 Jan;22(1):1-35. doi: 10.1111/ner.12845. Epub 2018 Sep 24.
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.
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.
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.
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.
神经调节适宜性共识委员会(NACC)致力于提高神经调节的安全性和有效性,从而改善接受神经调节治疗患者的生活。随着神经调节技术的不断创新,对最佳实践进行不断更新的评估变得很有必要。背根神经节(DRG)刺激在治疗复杂区域疼痛综合征(CRPS)等病症方面取得了显著进展。通过国际神经调节学会(INS)的资金支持和组织领导,NACC重新召集会议,以制定关于选择、植入和使用DRG刺激治疗慢性疼痛综合征的最佳实践共识文件。
NACC对1995年至2017年6月期间发表的有关DRG的文章进行了全面的文献检索。然后对总共2538篇文章摘要进行了审查,并根据美国预防服务工作组制定的评分标准对所选文章的证据强度进行了分级。在考虑分级证据的同时结合临床经验,形成了最佳实践共识和建议。
NACC基于同行评审文献和经验达成共识,形成了共识要点,以改善患者选择、指导手术方法、改善术后护理,并对接受DRG刺激治疗的患者管理提出建议。
NACC的建议旨在改善在这种不断发展的慢性疼痛治疗方法中的患者护理。选择遵循这些建议的临床医生可能会改善治疗效果。