References

Proclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.

Deer TR, Levy RM, Kramer J, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017;158(4):669-681.

Henderson, Jaimie M., et al. "NANS training requirements for spinal cord stimulation devices: selection, implantation, and follow‐up." Neuromodulation: Technology at the Neural Interface 12.3 (2009): 171-174.

Deer, Timothy R., et al. "The Neurostimulation Appropriateness Consensus Committee (NACC) recommendations for infection prevention and management." Neuromodulation: Technology at the Neural Interface1 (2017): 31-50.

Deer, Timothy R., et al. "The neurostimulation appropriateness consensus committee (NACC) safety guidelines for the reduction of severe neurological injury." Neuromodulation: Technology at the Neural Interface1 (2017): 15-30.

Deer, Timothy R., et al. "The neuromodulation appropriateness consensus committee on best practices for dorsal root ganglion stimulation." Neuromodulation: Technology at the Neural Interface1 (2019): 1-35.

Deer, Timothy R., et al. "Novel Intermittent Dosing Burst Paradigm in Spinal Cord Stimulation." Neuromodulation: Technology at the Neural Interface (2020).

Tavel, Edward, et al. “Programming Optimization Strategies for Burst may Improve Outcomes.” NANS, Las Vegas, USA, 2017.

*Smarter stimulation” described in the podcast at 15:53 is referring to neurostimulation with novel waveforms or parameters, and should not be described as “smart stimulation".

 

Rx OnlyBrief Summary: Prior to using these devices, please review the User’s Guide for a complete listing of indications, contraindications, warnings, precautions, potential adverse events, and directions for use. The system is intended to be used with leads and associated extensions that are compatible with the system.

DRG

Indications for Use:

US: Spinal column stimulation via epidural and intra-spinal lead access to the dorsal root ganglion as an aid in the management of moderate to severe chronic intractable* pain of the lower limbs in adult patients with Complex Regional Pain Syndrome (CRPS) types I and II.**

*Study subjects from the ACCURATE clinical study had failed to achieve adequate pain relief from at least 2 prior pharmacologic treatments from at least 2 different drug classes and continued their pharmacologic therapy during the clinical study.

**Please note that in 1994, a consensus group of pain medicine experts gathered by the International Association for the Study of Pain (IASP) reviewed diagnostic criteria and agreed to rename reflex sympathetic dystrophy (RSD) and causalgia, as complex regional pain syndrome (CRPS) types I and II, respectively. CRPS II (causalgia) is defined as a painful condition arising from damage to a nerve. Nerve damage may result from traumatic or surgical nerve injury. Changes secondary to neuropathic pain seen in CRPS I (RSD) may be present, but are not a diagnostic requirement for CRPS II (causalgia).

International: Management of chronic intractable pain.

Contraindications:

US: Patients who are unable to operate the system, who are poor surgical risks. Patients who have failed to receive effective pain relief during trial stimulation.

International: Patients who are unable to operate the system, are poor surgical risks, are pregnant, or under the age of 18.

Warnings/Precautions: Diathermy therapy, implanted cardiac systems or other active implantable devices, magnetic resonance imaging (MRI), computed tomography (CT), electrosurgery devices, ultrasonic scanning equipment, therapeutic radiation, explosive and flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery, equipment and vehicles, pediatric use, pregnancy, and case damage.

Adverse Effects: Unpleasant sensations, changes in stimulation, stimulation in unwanted places, le