This concurrent session serves to not only highlight the expansive indications for peripheral nerve stimulation (PNS), but also limitations in understanding PNS appropriateness relative to neuraxial neuromodulation treatments such as spinal cord stimulation (SCS) and dorsal root ganglion stimulation (DRGS). This session will be conducted in a PRO/CON format wherein PNS is compared to SCS and DRGS in the context of treating 1) complex regional pain syndrome, 2) Non-Surgical Refractory Low Back Pain, and 3) focal distribution neuropathic pain. These indications were chosen given that there exists some evidence basis supporting both PNS and neuraxial neurostimulation use in their treatments, but also a death of evidence comparing the two modalities. Attendees to this session will gain valuable insights and perspectives in comparing these neuromodulation modalities for the various highlighted pain indications such that they can adopt learnt principles and practice paradigms into their own clinical decision pathways. Importantly, all speakers in this panel have both clinical and research perspectives to substantiate their discussions. As PNS utilization continues to evolve, a nuanced understanding of the appropriate utilization of this therapy in the neuromodulation space is imperative. We believe that this session will also serve to inspire future clinical practice and research questions.

Fellow, Neurosurgeon, Neurologist, Physician, Physician’s Assistant, Pain Medicine Physician, Physical Medicine and Rehab Physician, Researcher, Resident, Scientist

1. To identify indications for and limitations with PNS utilization.

2. To compare PNS to SCS and DRGS in context of complex regional pain syndrome,  Non-Surgical Refractory Low Back Pain, and  focal distribution neuropathic pain.

3. To better determine appropriateness of differing neuromodulation therapies for treatment of these painful conditions.

Jay Karri, MD, MPH; Nasir Hussain, MD, MSc; Saba Javed, MD; David Dickerson, MD; Christopher Gilligan, MD; Matthew Chung, MD; John Hatheway, MD; and Kaijie Wang

Any faculty member not on the disclosure list has reported nothing to disclose.
 
Matthew Chung, MD | Speaker
Saluda Medical: Consulting Fees (Ongoing)

David Dickerson, MD | Speaker
Abbott/St. Jude Medical: Consulting Fees (Ongoing)|Abbott/St. Jude Medical: Contracted Research (Ongoing)|Abbott/St. Jude Medical: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus) (Ongoing)|Abbott/St. Jude Medical: Speakers' Bureau (Ongoing)|Biotronik: Contracted Research (Ongoing)|Biotronik: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus) (Ongoing)|Biotronik: Speakers' Bureau (Ongoing)|SPR therapeutics: Consulting Fees (Ongoing)|SPR therapeutics: Contracted Research (Ongoing)|SPR therapeutics: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus) (Ongoing)|SPR therapeutics: Speakers' Bureau (Ongoing)|Vertex: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus) (Ongoing)|Vertos: Consulting Fees (Ongoing)|Vertos: Fees for Non-CME Services Received Directly from Commercial Interest or their Agents (e.g., speakers' bureaus) (Ongoing)|Vertos: Speakers' Bureau (Ongoing)

Christopher Gilligan, MD | Speaker
Biotronik: Consulting Fees (Ongoing)|Iliad Lifesciences: Consulting Fees (Ongoing)|Mainstay Medical: Consulting Fees (Ongoing)|Mainstay Medical: Stock Options (Ongoing)|Persica: Consulting Fees (Ongoing)|Saluda Medical: Consulting Fees (Ongoing)

John Hatheway, MD | Oral Abstract Presenter
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Welcome
Jay Karri, MD, MPH and Nasir Hussain, MD, MSc

Treating Complex Regional Pain Syndrome- Pro: Favor PNS as a treatment modality
Saba Javed, MD

Treating Complex Regional Pain Syndrome- Con: Favor DRGS as a treatment modality
David Dickerson, MD

Treating Non-Surgical Refractory Low Back Pain- Pro: Favor PNS (including restorative neurostimulation) as a treatment modality
Christopher Gilligan, MD
    
Treating Non-Surgical Refractory Low Back Pain- Con: Favor SCS as a treatment modality
Nasir Hussain MD, MSc

Treating Focal Distribution Neuropathic Pain- Pro: Favor PNS as a treatment modality
Jay Karri, MD, MPH

Treating Focal Distribution Neuropathic Pain- Con: Favor SCS/DRGS as a treatment modality
Matthew Chung, MD

Oral Abstract Presentation: Pain Outcomes from the COMFORT 2 Randomized Control Trial for Peripheral Nerve Stimulation- Early Results
John Hatheway, MD

Oral Abstract Presentation: Real World Data Shows Long-Term Pain Relief with Peripheral Nerve Stimulation Delivered from Micro-IPG
John Hatheway, MD

Oral Abstract Presentation: Anti-inflammatory mechanism and central pathway of auricular vagal nerve stimulation on visceral hyperalgesia in rats
Kaijie Wang

Closing Discussion
Jay Karri, MD, MPH and Nasir Hussain, MD, Msc

Educational Programs (except the in-person Annual Meeting) – Fees for programs are non-refundable. For more information, please visit the NANS website for the full refund policy

This is activity is not eligible for CME credit.