The North American Spine Society opened a 30-day comment period on coverage recommendations for lumbar interspinous devices without fusion and decompression Feb. 8. You can find a draft of the proposed coverage policy recommendations here.
The recommendation covers interspinous devices that are intended for use in conjunction
with direct decompressive procedures. The draft policy states:
"Stabilization with an interspinous device without fusion in conjunction with laminectomy may be indicated as an alternative to lumbar fusion for degenerative lumbar stenosis with or without low-grade spondylolisthesis (less than or equal to 3 mm of anterolisthesis on a lateral radiograph) with qualifying criteria when appropriate."
The qualifying criteria includes significant mechanical back pain that likely wouldn't improve alone; lumbar fusion is indicated after decompression based on the NASS Coverage Recommendations for Lumbar Fusion; or lumbar laminectomy is indicated based on the NASS Coverage Recommendations for Lumbar Laminectomy.
The coverage recommendation would not include patients with grade II or higher degenerative spondylolisthesis, degenerative scoliosis, signs of coronal instability or dynamic instability.
NASS invites comments to coverage@spine.org through March 10. The organization also recently released coverage recommendations for allograft and demineralized bone matrix for spinal fusion and spinal cord stimulation, which you can find here.