Moreover, these researchers stated that additional non-industry funded, high-quality research and perhaps a more generalizable patient population is needed to confirm these findings. The 4-year Superion data were extracted from a randomized, controlled FDA IDE. Furthermore, this study provided only short-term follow-up (up to 2 years); long-term follow-up data are needed. They stated that these findings suggested that minimally invasive SIJ arthrodesis may be a reasonable option for patients with SIJ pain not responsive to 6 months of conservative management. Once inside the spinal canal, the catheter can be maneuvered to multiple levels of the lumbar spine, both sides. Intracept System (intra-osseous basivertebral nerve ablation) for the treatment of low back pain, and neck pain; Intradiscal injections of notochordal cell-derived matrix for the treatment of intervertebral disc disease; Intradiscal injection of platelet-rich plasma; Intradiscal, paravertebral, or epiduraloxygen or ozone injections; Intramuscular steroid injection for the treatment of back pain, neck pain. A cadaveric study assessing the accuracy of ultrasound-guided sacroiliac joint injections. He also received personal fees from Boston Scientific and Vertiflex, outside the submitted work. Its a common condition that can affect anyone, although it happens more often in men and in people who are overweight. Int J Surg. Database of Abstracts of Reviews of Effectiveness (DARE). These researchers stated that the findings of this study suggested that implantation with an annular closure device represented a safe and durable preventative strategy in patients at high risk for lumbar disc re-herniation following microdiscectomy. Outcome measures included general health and function, clinical evaluation, and radiographic assessment. A stratified comparative analysis of 6130 patients. Surg Neurol. The improvements in ODI in this study were similar to those reported after percutaneous SI joint fusion. Kim et al (2017) reported the surgical procedure and preliminary clinical results of percutaneous endoscopic stenosis lumbar decompression (PESLD) technique using a uniportal-contralateral approach for bilateral decompression of degenerative spinal stenosis. Because this dose was well-tolerated, these investigators would use the same dosage in future investigations. Learn more here. Automated percutaneous discectomy refers to techniques using minimal skin incisions (generally several, all less than 3 to 5 mm) to allow small instruments to be inserted, using radiography to visualize these instruments, and using extensions for the surgeon to reach the operative site without having to dissect tissues. The surgical defect in the annulus fibrosus is typically left unrepaired after lumbar discectomy. Outcomes were measured at pre-operation and at 1 week, 1, 3, 6, 12, and 24 months post-operation. Washington State Department of Labor and Industries. 2005;30(9):1019-1029; discussion 1030. Skeppholm M, Olerud C. Pain from donor site after anterior cervical fusion with bone graft: A prospective randomized study with 12 months of follow-up. Sachs D, Capobianco R. One year successful outcomes for novel sacroiliac joint arthrodesis system. Functional results of percutaneous laser discectomy. Scott NA, Guo B, Barton PM, Gerwin RD. However, these investigators noted that an open-label study design is acceptable in a post-market environment where the treatment effect has previously been demonstrated in comparison to a sham procedure, and treatment outcomes have remained consistent across studies and through long-term follow-up; further suggesting that improvements are largely due to the intervention. Hypertension: Can 15 minutes of yoga a day help control blood pressure? A finite element model was used to calculate TFAS bone-implant interface loads. Two evidence-based reviews concluded that there is not sufficient evidence to support their use. Outcome measurements included radiographic assessment for fusion and improvement in VAS for LBP, leg pain, and dyspareunia. 2019;13(2):110-119. The FH increased from (19.82 2.38) mm to (22.28 2.95) mm (p < 0.05) post-operatively, and the FH decreased to (19.31 3.32) mm at the last follow up(p > 0.05, compared to the post-operation). Transforaminal endoscopic lumbar discectomy for lumbar disc herniation causing bilateral symptoms. 2012;93(11):859-870. A sub-group of patients treated with the endoscopic IC technique was identified. Many effective chronic pain interventions, such as spinal cord stimulation, fail to demonstrate reduction in opioid use. These researchers stated that in the light of several limitations of this trial, a RCT is considered imperative. Clinical Practice Guideline No. Long-term biomechanical stability and clinical improvement after multilevel corpectomy and circumferential reconstruction of the cervical spine using titanium mesh cages. 2 Significantly different from men for same race and Hispanic-origin group. Opioid use was stratified into 3 groups by 2 blinded external reviewers. Assessment of radiographic and clinical outcomes of an articulating expandable interbody cage in minimally invasive transforaminal lumbar interbody fusion for spondylolisthesis. Greater improvement in disability and QOL was also shown in the surgical group with results lasting through 2 years. Response to: Cheng et al. A database was prospectively developed to record all complaints reported to the manufacturer in patients treated with the iFUSE device. It can reduce the influence on adjacent segments and delay degeneration, which improves spine stability. 1989;24(5):718-721. Secondary outcomes included NRS scores at 24 hours, 72 hours, 1 week, and 3 months after injection, physical functioning at 1 month after the procedure, procedure time, incidence of intra-articular and peri-articular needle placement, patient discomfort, overall patient satisfaction, and daily opioid consumption. Isaacsand associates(2005) retrospectively compared 20 patients receiving MITLIF with 24 patients receiving traditional PLIF. Chou R, Baisden J, Carragee EJ, et al. J Manipulative Physiol Ther. Pain associated with piriformis syndrome is exacerbated in prolonged sitting. Minimally invasive SI joint fusion surgery with iFuse is also more effective than open fusion for reducing pain and is associated with a shorter hospital length of stay. Factors associated with failure of trigger point injections Clin J Pain. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health (CADTH); 2006. Mekhail N, Costandi S, Abraham B, Samuel SW. Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression. J Spinal Disord Tech. Urits I, Noor N, Johal AS, et al. Int J Spine Surg. Neurosurgery. The device is intended to maintain bone graft material within a vertebral defect. The percentage of women who have severe obesity (11.5%) is higher than the percentage of men who have severe obesity (6.9%). Between June 6, 2013, and May 15, 2015, a total of 103 subjects were randomly assigned to conservative management (n = 51) or SIJ arthrodesis (n = 52). Huang T, Tian Z, Li M, et al. Among children ages 6 to 11, the prevalence of obesity increased between 19881994 and 20032004, fluctuated over the next several years, and most recently (20132014 to 20172018) increased. NOTE: Excludes pregnant females. 2015;76(1):7-23; discussion 23-24. J Spinal Disord Tech. A drop-out effect could have altered the overall outcome of the study. There were no specific abnormal findings on laboratory testing and radiological examinations. A case series. A positive discogram requires the reproduction of the patient's typical pain at an intensity of greater than 6/10 at a pressure of less than 15 psi above opening pressure and at a volume less than 3.0 ml. Spinal mechanisms of pain control. Disabil Rehabil. Ref. the lack of a sham control (i.e., incision and dissection to the ilium, possible drilling, but no implant placement). A higher incidence of revision for symptomatic pseudarthrosis occurred in the PEEK group; however, this was not statistically significant. Significant improvements were seen in final LBP score on a VAS (0 to 10) (average improvement 4.9, p < or = 0.001). For additional language assistance: Sacrococcygeal disorders, not elsewhere classified [for individuals with coccygodynia who have tried and failed to respond to 6 months of conservative management], Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), cervical or thoracic; single level, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level, Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level, Epidurography, radiological supervision and interpretation, Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation, Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), Magnetic resonance guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation, Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg, Injection, methylprednisolone acetate, 20 mg, Injection, methylprednisolone acetate, 40 mg, Injection, methylprednisolone acetate, 80 mg, Injection, dexamethasone sodium phosphate, 1mg, Injection, hydrocortisone acetate, up to 25 mg, Injection, hydrocortisone sodium phosphate, up to 50 mg, Injection, hydrocortisone sodium succinate, up to 100 mg, Injection, prednisolone acetate, up to 1 ml, Injection, methylprednisolone sodium succinate, up to 40 mg, Injection, methylprednisolone sodium succinate, up to 125 mg, Injection, triamcinolone acetonide, preservative free, 1 mg, Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Injection, triamcinolone diacetate, per 5mg, Injection, triamcinolone hexacetonide, per 5mg, Cervicocranial - cervicobrachial syndrome, Other specified dorsopathies [cervical region], Malignant neoplasm of pelvic bones, sacrum and coccyx, Secondary malignant neoplasm of bone [vertebral column], Benign neoplasm of pelvic bones, sacrum and coccyx, Neoplasm of uncertain behavior of bone and articular cartilage [vertebral column], Neoplasm of unspecified behavior of bone, soft tissue, and skin [vertebral column], Infection of intervertebral disc (pyogenic), Age-related osteoporosis with current pathological fracture, vertebra(e), Other osteoporosis with current pathological fracture, vertebra(e), Pathological fracture, other site [vertebrae], Pathological fracture in neoplastic disease, other specified site [vertebrae], Pathological fracture in other disease, other site [vertebrae], Fracture of cervical vertebra and other parts of neck, Injection, anesthetic agent; other peripheral nerve or branch [coccygeal ganglion (ganglion impar) block], Sacrococcygeal disorders, not elsewhere classified [coccygodynia], Injection(s); single or multiple trigger point(s), 1 or 2 muscles(s) [no repeats more than every 7 days, up to four sets to diagnose and achieve therapeutic effect, no additional sets if no clinical response, once diagnosed and therapeutic effect achieved, no repeats more than once every two months and beyond 12 months requires clinical review], single or multiple trigger point(s), 3 or more muscles(s) [no repeats more than every 7 days, up to four sets to diagnose and achieve therapeutic effect, no additional sets if no clinical response, once diagnosed and therapeutic effect achieved, no repeats more than once every two months and beyond 12 months requires clinical review], Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure), Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure), Physical medicine and rehabilitation modalities and therapeutic procedures, Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid [up to two injections to diagnose and achieve therapeutic effect, no repeats more than once every 7 days, no additional injections more once every two months or beyond 12 months], Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography), Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, subarachnoid or sacroilliac joint), including neurolytic agent destruction, Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography, Injection procedure for sacroiliac joint; arthrography, Sciatica and lumbago [more than 3 months duration and part of a comprehensive pain management program, including physical therapy, patient education, psychosocial support, and oral medication where appropriate], Other spondylosis, lumbar region [lumbar facet degeneration], Other intervertebral disc displacement, lumbar region, Other intervertebral disc degeneration, lumbar region, Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance, Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT), Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance, Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT), Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminarepidural or subarachnoid, cervical or thoracic; without imaging guidance, Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT), Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance, Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT), Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); cervical or thoracic, single level, each additional level (List separately in addition to code for primary procedure), Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level, Injection, methylprednisone acetate, 20 mg, Injection, methylprednisone acetate, 40 mg, Injection, methylprednisone acetate, 80 mg, Cervical disc disorder with radiculopathy, Intervertebral disc disorders with radiculopathy, Malignant neoplasm of pelvic bones, sacrum, and coccyx, Secondary malignant neoplasm of other parts of nervous system [includes spinal cord], Secondary malignant neoplasm of bone and bone marrow, Benign neoplasm of pelvic bones, sacrum, and coccyx, Neoplasm of uncertain behavior of meninges, Neoplasm of uncertain behavior of brain and spinal cord, Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system, Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar, Myelography via lumbar injection, including radiological supervision and interpretation, Magnetic resonance (eg, proton) imaging, spinal canal and contents, Intervertebral disc disorders with myelopathy, lumbar/lumbosacral region, Other intervertebral disc displacement, lumbar/lumbosacral regions, Benign neoplasm of vertebral column [excludes sacrum and coccyx], Neoplasm of uncertain behavior of spinal cord, Spondylolysis, lumbar, lumbosacral, sacral and sacrococcygeal, region, M43.27 - M43.28M53.2x7 - M53.2x8M53.87 - M53.88, Other specified deforming dorsopathies, site unspecified, Thoracic, thoracolumbar intervertebral disc disorder with myelopathy, Other thoracic, thoracolumbar disc displacement, Spinal instabilities, lumbosacral, sacral, sacrococcygeal region, Postlaminectomy syndrome, not elsewhere classified, Complications of pregnancy, childbirth, and the puerperium, Other symptoms and signs involving the nervous and musculoskeletal systems, Encounter for supervision of normal pregnancy, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (eg, manual or automated percutaneous discectomy, percutaneous laser discectomy), Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes, Laminectomy, discectomy and related procedures (eg, decompression of spinal cord), Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (PILD) or placebo-control, performed in an approved coverage with evidence development (CED) clinical trial, Intervertebral disc disorder with myelopathy, lumbar/lumbosacral region, Percutaneous laminotomy/laminectomy (intralaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy) any method under indirect image guidance (eg, fluoroscopic, CT), with or without the use of an endoscope, single or multiple levels, unilateral or bilateral; cervical or thoracic, Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or CT); cervical or thoracic, single facet joint [not covered for cooled radiofrequency ablation], cervical or thoracic, each additional facet joint (List separately in addition to code for primary procedure) [not covered for cooled radiofrequency ablation], lumbar or sacral, single facet joint [not covered for cooled radiofrequency ablation], lumbar or sacral, each additional facet joint (List separately in addition to code for primary procedure) [not covered for cooled radiofrequency ablation], Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography), Injection, anesthetic agent and/or steroid, transforaminal epidural, M43.27 - M43.29, M53.2x7 - M53.2x8, M53.87 - M53.88, Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar, Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure), Malignant neoplasm of vertebral column, excluding sacrum and coccyx, Secondary malignant neoplasm of brain and spinal cord, Secondary malignant neoplasm of other parts of nervous system, Neoplasm of uncertain behavior of bone and articular cartilage, Osteomyelitis of vertebra, site unspecified, Infection of intervertebral disc (pyogenic), site unspecified, Spinal stenosis, lumbar and lumbosacral region, M48.50x+ - M48.58x+, M80.08x+, M84.48x+, M84.58x+, M84.68x+, Other acute osteomyelitis, other site [spinal], Subacute osteomyelitis, other site [spinal], Other chronic osteomyelitis, other site [spinal], Pseudoarthrosis after fusion or arthrodesis, Nonunion of fracture [Codes not listed due to expanded specificity], Unspecified open wound of lower back and pelvis without penetration into retroperitoneum, Subluxation and dislocation of lumbar vertebra, Other and unspecified injury of lumbar spinal cord, Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure), Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure), Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure), (e.g., BAK Interbody Fusion System, Ray Threaded Fusion Cage, STALIF stand-alone anterior lumbar fusion cage, carbon fiber cage), Loose body, other site [retropulsed bone fragments], Osteophyte, vertebrae [of spine causing spinal cord or nerve root compression, confirmed by imaging studies] [see criteria in CPB 743], Spinal stenosis, cervical region [symptomatic central canal stenosis], Cervical disc disorders with myelopathy [see criteria in CPB 743], Other cervical disc displacement [see criteria in CPB 743], Other thoracic, thoracolumbar and lumbosacral intevertebral disc degeneration [see criteria in CPB 743], Radiculopathy, cervical region [see criteria in CPB 743], Pseudarthrosis after fusion or arthrodesis, Congenital spondylolisthesis [see criteria in CPB 743], Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic or lumbosacral, each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure), Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic or lumbar, each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure), Intravertebral body fracture augmentation with implant (e.g., metal, polymer) [spineJack system], Malignant neoplasm of lymphoid, hematopoietic and related tissue, Hemangioma of other sites [painful and/or aggressive], Other specified metabolic disorders [painful vertebral eosinophilic granuloma], Pathological fracture of vertebra(e) [painful, debilitating osteoporotic collapse/compression fractures], Fracture of vertebral column, without mention of spinal cord injury [steroid-induced] [with spinal cord injury, use spinal cord injury codes also], Other specified deforming dorsopathies, site unspecified [damaged or unstable vertebral body resected or excised during total and partial vertebrectomy procedures], Collasped vertebra, not elsewhere classified, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug [Toradol] ); subcutaneous or intramuscular, Injection, ketorolac tromethamine per 15 mg [Toradol], Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, Injection(s); single tendon sheath, or ligament, aponeurosis, Needle insertion(s) without injection(s); 1 or 2 muscle(s), Needle insertion(s) without injection(s); 3 or more muscles, Intravenous infusion, for therapy, prophylaxis, or diagnosis, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular, Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar [Barricaid, DART disc annular repair devices, Xclose Tissue Repair System], Injection, dexamethasone sodium phosphate, 1 mg, Injection, ketorolac tromethamine per 15 mg, Injection, lidocaine HCL for intravenous infusion 10 mg, Injection, triamcinolone diacetate, per 5 mg, Injection, triamcinolone hexacetonide, per 5 mg, Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg, Injection, vitamin B-12 cyanocobalamin, up to 1000 mg, Injection, lidocaine hcl for intravenous infusion, 10 mg, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with the use of an endoscope, with discography and/or epidural injection(s) at the treated level(s), when performed, single or multiple levels, lumbar [not covered for endoscopic transforaminal discectomy], Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug [magnesium, Toradol and vitamin B12 cyanocobalamin] for the treatment of back pain), Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic, Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic, Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation [not covered for chemical ablation (including but not limited to alcohol, phenol or sodium morrhuate) of facet joints], epidural, cervical or thoracic [not covered for chemical ablation (including but not limited to alcohol, phenol or sodium morrhuate) of facet joints], epidural, lumbar, sacral (caudal) [not covered for chemical ablation (including but not limited to alcohol, phenol or sodium morrhuate) of facet joints], Injection, hyaluronidase, up to 150 units, Injection, hyaluronidase, ovine, preservative free, per 1 USP unit (up to 999 USP units), Injection, hyaluronidase, ovine, preservative free, per 1000 USP units, Injection, hyaluronidase, recombinant, 1 USP unit, Meningitis due to other and unspecified causes, Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; first 2 vertebral bodies, lumbar or sacral, Thermal destruction of intraosseous basivertebral nerve, including all imaging guidance; each additional vertebral body, lumbar or sacral (List separately in addition to code for primary procedure), Thoracic, thoracolumbar, and lumbosacral intervertebral disc disorders, Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy, Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace, Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, each additional interspace (list separately in addition to code for primary procedure), Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device, Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed [may be medically necessary for sacroiliac joint infection, tumor involving the sacrum, and sacroiliac pain due to severe traumatic injury where a trial of an external fixator is successful in providing pain relief], Direct infection of vertebrae in infectious and parasitic diseases classified elsewhere [sacroiliac joint infection], Other reactive arthropathies, vertebrae [sacroiliac joint infection], Sacroiliitis, not elsewhere classified [sacroiliac joint syndrome], Sacrococcygeal disorders, not elsewhere classified [sacroiliac joint syndrome], Radiculopathy, lumbosacral region [due to severe traumatic injury], Radiculopathy, sacral and sacrococcygeal region [due to severe traumatic injury], Hydroxyapatite deposition disease, vertebrae [lumbar], Familial chondrocalcinosis, vertebrae [lumbar], Other chondrocalcinosis, vertebrae [lumbar], Other specified crystal arthropathies, vertebrae [lumbar], Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed, Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed, Percutaneous lysis of epidural adhesions using solution injection (e.g., hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days, Osteotomy of spine, including discectomy, anterior approach, Osteotomy of spine, posterior or posterolateral approach, three columns, one vertebral segment (eg, pedicle/vertebral body subtraction); thoracic, each additional vertebral segment (List separately in addition to code for primary procedure), Osteotomy of spine, posterior or posterolateral approach, one vertebral segment; lumbar, each additional vertebral segment (List separately in addition to primary procedure), Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar, Aspiration or decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (eg, manual or automated percutaneous discectomy, percutaneous laser discectomy), Injection, anesthetic agent; intercostal nerve single, intercostal nerves, multiple, regional block, Other nerve root and plexus disorders [intercostal neuritis], Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level, Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure), Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level, Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure), Posterior vertebral joint(s) arthroplasty (e.g., facet joint[s] replacement) including facetectomy, laminectomy, foraminotomy and vertebral column fixation, with or without injection of bone cement, including fluoroscopy, single level, lumbar spine, Interspinous process distraction device (implantable), Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure), Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve [not covered for surgery for piriformis syndrome], Denervation, hip joint, intrapelvic or extrapelvic intrarticular branches of sciatic, femoral, or obturator nerves [not covered when specified as radiofrequency denervation for sacroiliac pain], Radiculopathy, thoracic or lumbosacral region, Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical, Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia), Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar.
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