The North American Spine Society has opened a 30-day public comment period for the recently developed draft coverage recommendations on allograft and demineralized bone matrix for spinal fusion and spinal cord stimulation.
The North American Spine Society (NASS) has recommended the use of structural allograft in anterior cervical spinal reconstruction during uninstrumented and instrumented single-level anterior cervical discectomy and fusion (ACDF), instrumented multilevel ACDF, cervical corpectomy and posterior occipitocervical fusion. When treating cervical radiculopathy or myelopathy with anterior cervical spinal reconstruction and fusion, NASS has recommended use of demineralized bone matrix in the posterior cervical spine. For spinal reconstruction, NASS has recommended structural allograft bone during anterior lumbar interbody fusion and anterior corpectomy and fusion. Nonstructural allograft bone was recommended for use in spinal reconstruction and fusion of the thoracolumbar spine during posterior instrumentation and fusion, according to NASS, while demineralized bone matrix combined with autograft is indicated for use in posterior instrumented fusion.
NASS has also recommended spinal cord stimulation trial for patients who have moderate to severe pain that causes a functional deficit, pain for at least 6 months despite nonsurgical treatment and no identifiable cause for the pain that can be reasonably addressed with surgery or the risks of surgery are too high. If a patient has at least a 50% reduction in pain and some improvement in functional status for at least 48 hours after a spinal cord stimulation trial, NASS has recommended spinal cord stimulation implantation.
The society will accept public feedback on the new recommendations until May 20, 2017, which can be submitted by sending an email to firstname.lastname@example.org.
Comments will be reviewed and considered by the NASS Coverage Committee and, where appropriate, the committee will make edits before publishing the final recommendations.