• Neuromodulation · Aug 2024

    Review

    The Neurostimulation Appropriateness Consensus Committee (NACC)®: Recommendations for Spinal Cord Stimulation Long-term Outcome Optimization and Salvage Therapy.

    • Timothy R Deer, Marc Russo, Jay S Grider, Dawood Sayed, Tim J Lamer, David M Dickerson, Jonathan M Hagedorn, Erika A Petersen, Michael A Fishman, James FitzGerald, Ganesan Baranidharan, Dirk De Ridder, Krishnan V Chakravarthy, Adnan Al-Kaisy, Corey W Hunter, Eric Buchser, Kenneth Chapman, Chris Gilligan, Salim M Hayek, Simon Thomson, Natalie Strand, Jessica Jameson, Thomas T Simopoulos, Ajax Yang, Olivier De Coster, Fabián Cremaschi, Paul J Christo, Vishal Varshney, Stana Bojanic, and Robert M Levy.
    • The Spine and Nerve Center of the Virginias, Charleston, WV, USA. Electronic address: doctdeer@aol.com.
    • Neuromodulation. 2024 Aug 1; 27 (6): 951976951-976.

    IntroductionThe International Neuromodulation Society (INS) has recognized a need to establish best practices for optimizing implantable devices and salvage when ideal outcomes are not realized. This group has established the Neurostimulation Appropriateness Consensus Committee (NACC)® to offer guidance on matters needed for both our members and the broader community of those affected by neuromodulation devices.Materials And MethodsThe executive committee of the INS nominated faculty for this NACC® publication on the basis of expertise, publications, and career work on the issue. In addition, the faculty was chosen in consideration of diversity and inclusion of different career paths and demographic categories. Once chosen, the faculty was asked to grade current evidence and along with expert opinion create consensus recommendations to address the lapses in information on this topic.ResultsThe NACC® group established informative and authoritative recommendations on the salvage and optimization of care for those with indwelling devices. The recommendations are based on evidence and expert opinion and will be expected to evolve as new data are generated for each topic.ConclusionsNACC® guidance should be considered for any patient with less-than-optimal outcomes with a stimulation device implanted for treating chronic pain. Consideration should be given to these consensus points to salvage a potentially failed device before explant.Copyright © 2024. Published by Elsevier Inc.

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