Spinal Cord Stimulation in Special Populations: Best Practices from the American Society of Pain and Neuroscience to Improve Safety and Efficacy

Jennifer M. Lee, David Lee, Sandy Christiansen, Jonathan M. Hagedorn, Zheyan Chen, Timothy Deer

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic bleeding disorders, allergy to implants, and chronic infections are all complicating factors when considering neuromodulation therapies. The American Society of Pain and Neuroscience (ASPN) determined a need for clinical guidance in these special patient populations that have increased risk of complications, in order to ensure patient safety and optimal outcomes with device implantation. The purpose of this publication was to review the published literature and explore the unique clinical challenges encountered among several special patient populations with relation to spinal cord stimulation. The executive board of the ASPN appointed a diverse group of well-established physicians to develop best practice guidelines regarding spinal cord stimulation implantation in these special populations. The physicians used the United States Preventive Services Task Force (USPSTF) structured guidelines for grading and level of certainty to make evidence-based recommendations about clinical practice. Where sufficient evidence was lacking to justify a USPSTF ranking, the physicians queried experts in neuromodulation and achieved consensus. These best practices and interventional guideline found the evidence for the use of neuromodulation in specialized patient populations to be relatively modest.

Original languageEnglish (US)
Pages (from-to)3263-3273
Number of pages11
JournalJournal of Pain Research
Volume15
DOIs
StatePublished - 2022

Keywords

  • epidural abscess
  • epidural hematoma
  • guidelines
  • metallurgic allergy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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