Showing papers by "Jay S. Grider published in 2022"
TL;DR: The Neuro Stimulation Appropriateness Consensus Committee (NACC) project as discussed by the authors provides evidence-based guidance for these often-overlooked areas of neurostimulation practice.
Abstract: 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.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.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.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.
7 citations
TL;DR: The ASPN Back Guideline as mentioned in this paper provides clinicians with a comprehensive review of interventional treatments for lower back disorders, evaluating the appropriateness, effectiveness, and safety of these treatments.
Abstract: Introduction Painful lumbar spinal disorders represent a leading cause of disability in the US and worldwide. Interventional treatments for lumbar disorders are an effective treatment for the pain and disability from low back pain. Although many established and emerging interventional procedures are currently available, there exists a need for a defined guideline for their appropriateness, effectiveness, and safety. Objective The ASPN Back Guideline was developed to provide clinicians the most comprehensive review of interventional treatments for lower back disorders. Clinicians should utilize the ASPN Back Guideline to evaluate the quality of the literature, safety, and efficacy of interventional treatments for lower back disorders. Methods The American Society of Pain and Neuroscience (ASPN) identified an educational need for a comprehensive clinical guideline to provide evidence-based recommendations. Experts from the fields of Anesthesiology, Physiatry, Neurology, Neurosurgery, Radiology, and Pain Psychology developed the ASPN Back Guideline. The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Scopus, and meeting abstracts to identify and compile the evidence (per section) for back-related pain. Search words were selected based upon the section represented. Identified peer-reviewed literature was critiqued using United States Preventive Services Task Force (USPSTF) criteria and consensus points are presented. Results After a comprehensive review and analysis of the available evidence, the ASPN Back Guideline group was able to rate the literature and provide therapy grades to each of the most commonly available interventional treatments for low back pain. Conclusion The ASPN Back Guideline represents the first comprehensive analysis and grading of the existing and emerging interventional treatments available for low back pain. This will be a living document which will be periodically updated to the current standard of care based on the available evidence within peer-reviewed literature.
7 citations
TL;DR: The International Neuromodulation Society (NACC) as mentioned in this paper developed evidence-based guidance for the use of neurostimulation in the cervical region to improve outcomes, based on the strength of evidence or consensus when evidence was scant.
Abstract: The International Neuromodulation Society convened a multispecialty group of physicians based on expertise with international representation to establish evidence-based guidance on the use of neurostimulation in the cervical region to improve outcomes. This Neurostimulation Appropriateness Consensus Committee (NACC) project intends to provide evidence-based guidance for an often-overlooked area of neurostimulation practice.Authors were chosen based upon 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 2017 (when NACC last published guidelines) to the present. Identified studies were graded using the US Preventive Services Task Force criteria for evidence and certainty of net benefit. Recommendations are based on the strength of evidence or consensus when evidence was scant.The NACC examined the published literature and established evidence- and consensus-based recommendations to guide best practices. Additional guidance will occur as new evidence is developed in future iterations of this process.The NACC recommends best practices regarding the use of cervical neuromodulation to improve safety and efficacy. The evidence- and consensus-based recommendations should be utilized as a guide to assist decision making when clinically appropriate.
4 citations
TL;DR: ASPN created a guidance for best practice for minimally invasive surgical treatment of symptomatic spinal stenosis, and identified peer-reviewed literature was critiqued using USPSTF criteria and consensus points are presented.
Abstract: Introduction Lumbar spinal stenosis (LSS) is a common spinal disease of aging with a growing patient population, paralleling population growth. Minimally invasive treatments are evolving, and the use of these techniques needs guidance to provide the optimal patient safety and efficacy outcomes. Methods The American Society of Pain and Neuroscience (ASPN) identified an educational need for guidance on the prudent use of the innovative minimally invasive surgical therapies for the treatment of symptomatic LSS. The executive board nominated experts spanning anesthesiology, physiatry, orthopedic surgery, and neurosurgery based on expertise, publications, research, diversity and field of practice. Evidence was reviewed, graded using the United States Preventive Services Task Force (USPSTF) criteria for evidence and recommendation strength and grade, and expert opinion was added to make consensus points for best practice. Results The world literature in English was searched using Medline, EMBASE, Cochrane CENTRAL, BioMed Central, Web of Science, Google Scholar, PubMed, Current Contents Connect, Scopus, and meeting abstracts to identify and compile the evidence (per section) for LSS-related pain. Search words were selected based upon the section represented. Identified peer-reviewed literature was critiqued using USPSTF criteria and consensus points are presented. Discussion The algorithm for patient selection in the management of symptomatic spinal stenosis is evolving. Careful consideration of patient selection and anatomic architecture variance is critical for improved outcomes and patient safety. Conclusion ASPN created a guidance for best practice for minimally invasive surgical treatment of symptomatic spinal stenosis.
3 citations
TL;DR: In this article , the authors used Intrathecalcific Ziconotide to treat refractory nociceptive and neuropathic pain via selective blockade of N-type calcium channels.
Abstract: Chronic refractory pain can be difficult to manage. Intrathecal Ziconotide has proven to be effective at treating refractory nociceptive and neuropathic pain. Ziconotide’s analgesic effect is via selective blockade of N-type calcium channels. Ziconotide is trialed with a bolus of 3 mcg or 5 mcg. After intrathecal pump implant, therapy is initiated at 1.2-2.4 mcg/day. After 7-14 days the medication is exchanged and the dose kept the same. Subsequently, the dose is titrated every 7-14 days by 0.5-1.2 mcg/day. Adverse events of Ziconotide include neuropsychiatric adverse events and is contraindicated in patients with a history of psychosis.
1 citations
TL;DR: In this paper , the effect of adding IT bupivacaine to an intrathecal dosing regimen in non-cancer patients with pain refractory to traditional therapy was evaluated.
Abstract: Intrathecal (IT) opioids are often used for treating chronic pain in patients refractory to conventional medical treatment or intolerant to side effects. Currently, there is little research on the efficacy of adding bupivacaine to an intrathecal dosing regimen in non-cancer patients with pain refractory to traditional therapy. This study aims to evaluate the effect of adding IT bupivacaine on opioid escalation and pain scores of all the patients in our practice who were initially implanted with opioid monotherapy
1 citations