Policy Statements

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 […]

ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (December 2015) Updated December 4, 2015 (This supplements the ISASS Policy Statement – Minimally Invasive Sacroiliac Joint Fusion (2014)) Morgan P. Lorio, MD, FACS Neuro-Spine Solutions, Bristol, TN A PDF version of the policy statement is available here. 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 […]