New ISASS guidelines recommend coverage of interlaminar stabilisation in certain lumbar stenosis cases


The International Society for the Advancement of Spine Surgery (ISASS) has issued a policy statement recommending the coverage of lumbar decompression with interlaminar stabilisation in carefully selected patients.

The document, “ISASS Recommendations/Coverage Criteria for Decompression with Interlaminar Stabilization – Coverage Indications, Limitations, and/or Medical Necessity” by Richard Guyer et al, was published in the International Journal of Spine Surgery, on November 10, 2016.

Per the statement, lumbar decompression with interlaminar stabilisation is recommended for coverage in selected lumbar spinal stenosis patients without gross instability, or in which the decompression procedure itself may create iatrogenic instability.

The statement notes that “there exists a population of patients who present with moderate to severe stenosis, with concomitant back pain, where decompression alone does not adequately address back pain.”

The statement recognises potential benefits of interlaminar stabilisation compared to fusion, and further states, “In select patients within the lumbar spinal stenosis continuum, decompression with interlaminar stabilisation has proven to provide equivalent outcomes with a reduced cost compared to decompression plus fusion.”