February 13, 2019

Vertebral Augmentation: Coverage Indications, Limitations, and/or Medical Necessity

Vertebral Augmentation: Coverage Indications, Limitations, and/or Medical Necessity OLIVIER CLERK-LAMALICE,1 DOUGLAS P. BEALL,2 KEVIN ONG,3 MORGAN P. LORIO4 1Western Canada Pain Institute, Edmonton, Alberta, Canada, 2Clinical Radiology of Oklahoma, Edmond, Oklahoma,3Exponent, Inc., Philadelphia, Pennsylvania, 4Hughston Clinic Orthopaedics—Centennial, Nashville, Tennessee ABSTRACT The ISASS Policy Statement on vertebral augmentation has the objectives to provide a background and an update with the latest clinical evidence for the international spine community. A SpineLine Panel Review (2010) appropriately recommended an exploration of ‘‘the seeming disconnect between the conclusions of . . . two [Level I] PRCT’s and previous experience and data’’ regarding vertebral augmentation. ISASS responded by supporting a comprehensive meta-analysis to help frame a cogent historical analysis of vertebral augmentation. This ISASS Policy 2018 […]
January 30, 2019

ISASS Recommendations and Coverage Criteria for Bone Graft Substitutes used in Spinal Surgery

ISASS Recommendations and Coverage Criteria for Bone Graft Substitutes used in Spinal Surgery CELESTE ABJORNSON, PHD,1 ANTONIO BRECEVICH, MD,1 TUCKER CALLANAN, MS,1 CHRISTINA DOWE, BS,1 FRANK P. CAMMISA, JR, MD,1 MORGAN P. LORIO, MD, FACS2 1Hospital for Special Surgery, New York, New York, 2Hughston Clinic Orthopaedics, Nashville, Tennessee   INTRODUCTION Over the past 3 decades, there has been an increased interest in bone grafting materials as these materials have become a vital part of most spinal procedures. Unlike other areas of orthopedics, spinal surgery often requires grafting procedures to induce de novo bone in an area stabilized by metal devices. When considering potential graft materials, assuming an adequate blood supply, it is important to note that a successful graft needs […]
November 10, 2016

ISASS Policy Statement – Decompression with Interlaminar Stabilization

ISASS Recommendations/Coverage Criteria for Decompression with Interlaminar Stabilization – Coverage Indications, Limitations, and/or Medical Necessity Authors: Richard Guyer, MD; Michael Musacchio, MD; Frank P. Cammisa, Jr., MD; and Morgan P. Lorio, MD, FACS   This paper was originally published here. A PDF version of this Policy Statement can be accessed here.   Introduction Broadly defined, lumbar spinal stenosis (LSS) is the progressive narrowing of the spinal canal and neural foramen resulting in pressure upon the nerve(s) leading to pain and/or numbness in the extremities, muscle weakness, bowel and bladder issues, and/or other pain related issues. However, the difficulty arises in that spinal stenosis is a heterogeneous condition with multiple etiologies which may present with disc height loss, facet hypertrophy, spondylolisthesis, retrolisthesis, coronal […]
July 7, 2016

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (July 2016)

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (July 2016) Updated July 5, 2016 (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   Rationale The index 2014 ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion was generated out of necessity to provide an ICD9-based background and emphasize tools to ensure correct diagnosis. A timely ICD10-based 2016 Update provides a granular threshold selection with improved level of evidence and a more robust, relevant database. Introduction The sacroiliac joints (SIJ) are diarthrodial articulations of the sacrum and ilium. The SIJ serves as the biomechanical mediator between the spine […]