Comité de Consenso sobre la Adecuación de la Neuroestimulación (NACC): Recomendaciones para la Técnica Quirúrgica para la Estimulación de la Médula Espinal: Publicado originalmente en la Revista Neuromodulation 2022; 25: 1–34. Traducción: Dr. Sergio Sacchettoni.

Timothy R. Deer; Marc A. Russo; Jay S. Grider; Jason Pope; Philippe Rigoard; Jonathan M. Hagedorn; Ramana Naidu; Denis G. Patterson; Derron Wilson; Timothy R. Lubenow; Asokumar Buvanendran; Samir J. Sheth; Rany Abdallah; N. Nick Knezevic; Stefan Schu; Harold Nijhuis; Pankaj Mehta; Ricardo Vallejo; Jay M. Shah; Michael E. Harned; Navdeep Jassal; José Manuel González; Thomas P. Pittelkow; Shachi Patel; Stana Bojanic; Kenneth Chapman; Natalie Strand; Alexander L. Green; Peter Pahapill; Alessandro Dario; Fabian Piedimonte; Robert M. Levy

doi:10.47924/neurotarget2023458

Authors

Timothy R. Deer The Spine and Nerve Centers of the Virginias, Charleston, WV, USA
Marc A. Russo Hunter Pain Specialists, Newcastle, New South Wales, Australia
Jay S. Grider UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
Jason Pope Evolve Restorative Center, Santa Rosa, CA, USA
Philippe Rigoard Department of Spine Surgery and Neuromodulation, PRISMATICS Lab, Poitiers University Hospital, Poitiers, France
Jonathan M. Hagedorn Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
Ramana Naidu California Orthopedics & Spine, Larkspur, CA, USA
Denis G. Patterson Nevada Advanced Pain Specialists, Reno, NV, USA
Derron Wilson Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
Timothy R. Lubenow Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
Asokumar Buvanendran Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
Samir J. Sheth Department of Anesthesiology and Pain Medicine, University of California, Davis, Davis, CA, USA
Rany Abdallah Center for Interventional Pain and Spine, Milford, DE, USA
N. Nick Knezevic Department of Anesthesiology and Surgery at University of Illinois, Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
Stefan Schu Leitender Arzt Neuromodulation, Neurochirurgie, Sana Kliniken Duisburg GmbH, Duisburg, Germany
Harold Nijhuis Department of Anesthesiology, St. Antonius Hospital, Nieuwegein, The Netherlands
Pankaj Mehta Pain Specialists of America, Austin, TX, USA
Ricardo Vallejo Millennium Pain Center, Bloomington, IL, USA
Jay M. Shah SamWell Institute for Pain Management, Colonia, NJ, USA
Michael E. Harned UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA
Navdeep Jassal Spine & Pain Institute of Florida, Lakeland, FL, USA
José Manuel Gonzáles Hospital Clínico Universitario Virgen de la Victoria, Servicio Andaluz de Salud, Málaga, Spain
Thomas P. Pittelkow Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
Shachi Patel Delmarva Spine and Pain Center, Newark, DE, USA
Stana Bojanic Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, England, UK
Kenneth Chapman Department of Anesthesiology, Perioperative Care, and Pain Medicine, The Pain and Spine Institute of New York, New York, NY, USA
Natalie Strand Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Phoenix, AZ, USA
Alexander L. Green Nuffield Department of Surgical Sciences, Oxford University, Oxford, England, UK
Peter Pahapill Functional Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
Alessandro Dario Department of Neurosurgery, ASST Settelaghi, Insubria University, Varese, Italy
Fabian Piedimonte Fundación CENIT—University of Buenos Aires, Buenos Aires, Argentina https://orcid.org/0000-0003-4661-4449
Robert M. Levy International Neuromodulation Society, Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA

DOI:

https://doi.org/10.47924/neurotarget2023458

Keywords:

Best practices, consensus, spinal cord stimulation, surgical technique, neurostimulation

Abstract

Introduction: The field of neurostimulation for the treatment of chronic pain is a rapidly developing area of medicine. Although neurostimulation therapies have advanced significantly as a result of technologic improvements, surgical planning, device placement, and postoperative care are of equal importance to optimize outcomes. This Neurostimulation Appropriateness Consensus Committee (NACC) project intends to provide evidence-based guidance for these often-overlooked areas of neurostimulation practice.
Materials and Methods: Authors were chosen based on their clinical expertise, familiarity with the peer-reviewed literature, research productivity, and contributions to the neuromodulation literature. Section leaders supervised literature searches of MEDLINE, BioMed Central, Current Contents Connect, Embase, International Pharmaceutical Abstracts, Web of Science, Google Scholar, and PubMed from the last NACC publication in 2017 to the present. Identified studies were graded using the United States Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on evidence strength and consensus when evidence was scant.
Results: This NACC project provides guidance on preoperative assessment, intraoperative techniques, and postoperative management in the form of consensus points with supportive evidence. These results are based on grade of evidence, strength of consensus, and expert opinion.
Conclusions: The NACC has given guidance for a surgical plan that encompasses the patient journey from the planning stage through the surgical experience and postoperative care. The overall recommendations are designed to improve efficacy and the safety of patients undergoing these neuromodulation procedures and are intended to apply throughout the international community.

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