Public Policy

March 15, 2015

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (March 2015)

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (March 2015) Updated March 15, 2015 (This supplements the ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (2014)) A PDF version of the policy statement is available here. Morgan P. Lorio, MD, FACS Neuro-Spine Solutions, Bristol, TN Introduction The sacroiliac joint (SIJ) is a cause of chronic lower back pain. SI joints are paired diarthrodial articulations of the sacrum and ilium. The SI joint serves as the biomechanical mediator between the spine and pelvis. The subchondral bone, capsule, and surrounding ligaments of the SIJ are innervated by spinal nerves.(1) Because SIJ pain can be confused with lumbar and hip pain, proper diagnosis of SIJ pain is key to appropriate patient management. […]
March 12, 2015

ISASS Policy Statement – Lumbar Artificial Disc

ISASS Policy Statement – Lumbar Artificial Disc   Jack Zigler, MD Texas Back Institute, Plano, TX Rolando Garcia, MD, MPH, FAAOS Orthopedic Care Center, Aventura, FL   This paper was originally published here. A PDF version of this Policy Statement can be accessed here.   Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel’s recommendation was entirely based on the best evidence-based scientific research available […]
August 22, 2014

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion Morgan P. Lorio, MD, FACS Neuro-Spine Solutions, Bristol, TN Ralph Rashbaum, MD Texas Back Institute, Plano, TX This paper was originally published here. A PDF version of the Policy Statement is available here. Background The sacroiliac (SI) joints are paired diarthrodial articulations of the sacrum and ilium and serve as the connection between the spine and pelvis. The small amount of motion in the joint (2-4 degrees) occurs primarily through nutation and counternutation of the sacrum.¹ There are no muscles that cross solely the SI joint, thus there are no prime movers. Instead, movement is dependent on the articulations and movement within the lumbopelvic hip complex (e.g. flexion at the hip results in […]
April 25, 2014

ISASS Responds to CBS Spinal Fusion Segment

CBS recently highlighted the fact that spinal fusions are increasingly common procedures and that indications in some cases are controversial. Their highlighting of “surgeons they looked into” presents a frightening picture of alleged abuses, of a procedure that in many cases is clinically indicated with excellent results. The controversy regarding fusion typically relates to its use in patients with chronic back pain of uncertain origin. For many non degenerative spinal conditions such as fractures, tumors, deformity, instability and infections there is no controversy about fusion surgery. Most diagnoses with a degenerative component including, but not limited to, adult degenerative deformity, spondylolisthesis and certain cases of spinal stenosis and disc degeneration have strong supporting evidence. The controversies in the CBS report […]