Robert M. Levy

Polyanalgesic consensus conference 2007: recommendations for the management of pain by intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel.

Background.  Expert panels of physicians and nonphysicians in the field of intrathecal therapies convened in 2000 and 2003 to make recommendations for the rational use of intrathecal analgesics based on the preclinical and clinical literature known up to those times. An expert panel of physicians convened in 2007 to update previous recommendations and to form guidelines for the rational use of intrathecal opioid and nonopioid agents.

The Appropriate Use of Neurostimulation of the Spinal Cord and Peripheral Nervous System for the Treatment of Chronic Pain and Ischemic Diseases: The Neuromodulation Appropriateness Consensus Committee

The Neuromodulation Appropriateness Consensus Committee (NACC) of the International Neuromodulation Society (INS) evaluated evidence regarding the safety and efficacy of neurostimulation to treat chronic pain, chronic critical limb ischemia, and refractory angina and recommended appropriate clinical applications.

A multicenter, prospective trial to assess the safety and performance of the spinal modulation dorsal root ganglion neurostimulator system in the treatment of chronic pain

This multicenter prospective trial was conducted to evaluate the clinical performance of a new neurostimulation system designed to treat chronic pain through the electrical neuromodulation of the dorsal root ganglia (DRG) neurophysiologically associated with painful regions of the limbs and/or trunk.

Polyanalgesic Consensus Conference--2012: recommendations to reduce morbidity and mortality in intrathecal drug delivery in the treatment of chronic pain.

Introduction:  Targeted intrathecal drug infusion to treat moderate to severe chronic pain has become a standard part of treatment algorithms when more conservative options fail. This therapy is well established in the literature, has shown efficacy, and is an important tool for the treatment of both cancer and noncancer pain; however, it has become clear in recent years that intrathecal drug delivery is associated with risks for serious morbidity and mortality.

Polyanalgesic Consensus Conference--2012: recommendations on trialing for intrathecal (intraspinal) drug delivery: report of an interdisciplinary expert panel.

Introduction:  Trialing for intrathecal pump placement is an essential part of the decision‐making process in placing a permanent device. In both the United States and the international community, the proper method for trialing is ill defined.

Incidence and avoidance of neurologic complications with paddle type spinal cord stimulation leads.

Introduction:  While reference is frequently made to the risk of spinal cord or nerve root injury with the surgical implantation of paddle type spinal cord stimulation (SCS) electrodes, data are lacking on the frequency, causes, and prevention of these complications.

Best practices for intrathecal drug delivery for pain.

The objective of this study was to identify best practices and provide guidance to clinicians to ensure safety and optimize intrathecal drug delivery for chronic intractable pain.

Polyanalgesic Consensus Conference—2012: Consensus on Diagnosis, Detection, and Treatment of Catheter‐Tip Granulomas (Inflammatory Masses)

Introduction:  Continuous intrathecal infusion of drugs to treat chronic pain and spasticity has become a standard part of the algorithm of care. The use of opioids has been associated with noninfectious inflammatory masses at the tip of the intrathecal catheter, which can result in neurologic complications.

Neurosurgical management of pain

1 Pain Physiology and Clinical Presentation.- 1. Physiology of Pain.- 2. Psychological and Psychiatric Aspects of Pain.- 3. Rehabilitation and Treatment Outcome.- 4A. Low Back Pain.- 4B. Low Back Pain.- 4C. Ischemic Pain.- 5. Chronic Nociceptive Pain Syndromes: Cancer Pain.- 6. Peripheral Nerve Injury and Sympathetically Maintained Pain: Mechanisms and Surgical Approach.- 7. Facial and Cranial Pain.- 8. Chronic Pain Syndromes of the Central Nervous System.- A. Phantom and Stump Pain.- B. Cervical Brachial Plexus Avulsion.- C. Central Pain of Spinal Cord Origin.- 9. Pharmacotherapy of Chronic Pain.- 2 Neurosurgical Procedures: Anatomic and Ablative.- 10. Neurosurgical Procedures of the Peripheral Nerves.- 11. Neurosurgical Procedures of the Sympathetic Nervous System.- 12. DREZ Lesions for Treatment of Pain.- 13. Cordotomy and Myelotomy.- 14. Trigeminal Nerve and Ganglion Procedures.- 15. Intracranial Ablative Procedures.- 3 Neurosurgical Procedures: Augmentative.- 16. Peripheral Nerve Stimulation.- 17. Spinal Cord Stimulation.- 18. Brain Stimulation.- 19. Implanted Drug Delivery Systems for Control of Chronic Pain.- 4 Algorithms and Guidelines.- 20. Facial Pain.- 21. Cancer Pain.- 22. Algorithms for Treatment of Neuropathic Pain Syndromes.- 23. Chronic Low Back Pain and Failed Back Surgery Syndrome.

The Appropriate Use of Neurostimulation: Avoidance and Treatment of Complications of Neurostimulation Therapies for the Treatment of Chronic Pain

The International Neuromodulation Society (INS) has determined that there is a need for guidance regarding safety and risk reduction for implantable neurostimulation devices. The INS convened an international committee of experts in the field to explore the evidence and clinical experience regarding safety, risks, and steps to risk reduction to improve outcomes.