The Neurostimulation Appropriateness Consensus Committee (NACC): Recommendations on Best Practices for Cervical Neurostimulation

Timothy R. Deer, Marc Russo, Jay S. Grider, Jason Pope, Jonathan M. Hagedorn, Jacqueline Weisbein, Alaa Abd-Elsayed, Ramsin Benyamin, Louis J. Raso, Kiran V. Patel, David Provenzano, Philip S. Kim, Kasra Amirdelfan, Robert Bolash, Monique Steegers, Richard Sullivan, Paul Verrills, Jon Carlson, Leo Kapural, Sudhir DiwanGiancarlo Barolat, Peter A. Pahapill, Jose De Andres, Ahmed M. Raslan, Jose A. Lopez, Michael S. Leong, Miguel B. Attias, Peter Teddy, Alexander L. Green, Alessandro Dario, Fabian Piedimonte, Kenneth B. Chapman, Nestor D. Tomycz, James FitzGerald, Kliment Gatzinsky, Vishal Varshney, Brandon Gish, Brad L. Lindsey, Asokumar Buvanendran, Tim J. Lamer, Konstantin V. Slavin, Robert M. Levy

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


Introduction: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)35-52
Number of pages18
Issue number1
StatePublished - Jan 2022


  • Best practices
  • cervical spinal cord stimulation
  • consensus
  • dorsal root ganglion
  • neuromodulation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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