Cda clinical practice guidelines 2013 pdf

Member’s activities of daily living are limited by persistent neck or cervico-brachial pain. Aetna considers subsequent placement of a second artificial cervical disc medically necessary at a level contiguous to a previous placed artificial disc when criteria for artificial discs are met. Aetna cda clinical practice guidelines 2013 pdf artificial cervical discs experimental and investigational for persons with prior disc replacement if the new request would result in more than 2 contiguous disc replacement levels from C3 to C7.

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Aetna considers concurrent or planned sequential artificial cervical disc replacement with cervical spinal fusion experimental and investigational for the management of neck pain, spinal disorders, and all other indications. Aetna considers artificial cervical discs experimental and investigational for persons with prior fusion or surgery at an adjacent cervical spine level. See also CPB 0016 – Back Pain – Invasive Procedures, and CPB 0743 – Spinal Surgery: Laminectomy and Fusion. The artificial disc was designed to restore normal disc height, to preserve the spinal flexibility and decrease degeneration of adjacent discs, which can occur as a result of DDD.

Most of the published clinical evidence for artificial prosthetic intervertebral discs has been of those that replace the entire disc. 27 patients who presented with unsatisfactory results or complications after Charite disc replacement. The patients were evaluated with plain radiography, some with flexion-extension x-rays, and most of them with computed tomography scans. The group consisted of 15 women and 12 men. Poor results were reported by four patients, one of whom underwent postero-lateral fusion and another is waiting for the same operation.