Facet Arthroplasty
DESCRIPTION
Facet arthroplasty refers to the implantation of a spinal prosthesis to restore posterior element structure and function as an adjunct to neural decompression. This procedure is proposed as an alternative to posterior spinal fusion for individuals with facet arthrosis, spinal stenosis, and spondylolisthesis. The objective of facet arthroplasty is to stabilize the spine while retaining normal intervertebral motion of the surgically removed segment following neural decompression. It is proposed that facet arthroplasty should also maintain the normal biomechanics of the adjacent vertebrae. If normal motion patterns are achieved by artificial joints in the spine, the risk of adjacent-level degeneration thought to be associated with fusion may be mitigated. No facet arthroplasty devices are approved by the U.S. Food and Drug Administration (FDA) at this time
POLICY
Total facet arthroplasty for the treatment of degenerative disc disease is considered investigational.
IMPORTANT REMINDERS
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SOURCES
BlueCross BlueShield Association. Evidence Positioning System. (5:2023). Facet arthroplasty (7.01.120). Retrieved June 28, 2023 from www.bcbsaoca.com/eps/. (4 articles and/or guideline reviewed)
Coric, D., Nassr, A., Kim, P K., Welch, W C., Robbins, S., DeLuca,S., et al. (2022). Prospective, randomized controlled multicenter study of posterior lumbar facet arthroplasty for the treatment of spondylolisthesis. Journal of Neurosurgery. Spine, 38 (1), 115-125. Abstract retrieved June 28, 2023 from PubMed database.
Sjovold, S., Zhu, Q., Bowden, A., Larson, C., de Bakker, P., Villarraga, M., et al. (2012). Biomechanical evaluation of the total facet arthroplasty system (TFAS): loading as compared to a rigid posterior instrumentation system. European Spine Journal, 2012, 21, 1660-1673. (Level 4 evidence)
Smorgick, Y., Mirovsky, Y., Floman, Y., Rand, N., Millgram, M., & Anekstein, Y. (2019). Long-term results for total lumbar facet joint replacement in the management of lumbar degenerative spondylolisthesis. Journal of Neurosurgery - Spine. doi:10.3171/2019.7.SPINE19150. Abstract retrieved July 7, 2020 from PubMed database.
ORIGINAL EFFECTIVE DATE: 1/9/2010
MOST RECENT REVIEW DATE: 8/10/2023
ID_BA
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