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Cervical Fusion Appropriate Use Criteria Work Groups Appropriate Use Criteria Cervical Fusion North American Spine Society 2013 North American Spine Society 1 Appropriate Use Criteria for Cervical Fusion This content of this document should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution. North American Spine Society 2 Appropriate Use Criteria for Cervical Fusion Cervical Fusion Appropriate Use Criteria Work Groups Oversight Charles A. Reitman, MD, Chair Orthopedic Surgery Christopher M. Bono, MD Orthopedic Surgery Zoher Ghogawala, MD Neurosurgery Christopher P. Kauffman, MD Orthopedic Surgery William Mitchell, MD Neurosurgery Daniel K. Resnick, MD, MS Neurosurgery Alok D. Sharan, MD Orthopedic Surgery Christopher J. Standaert, MD Physical Medicine & Rehabilitation Scenario Writing Group Christopher M. Bono, MD Orthopedic Surgery Zoher Ghogawala, MD Neurosurgery Charles A. Reitman, MD Orthopedic Surgery Christopher J. Standaert, MD Physical Medicine & Rehabilitation Scenario Reviewer Group Ray M. Baker, MD Pain Management & Medicine Michael H. Heggeness, MD, PhD Orthopedic Surgery Charles A. Mick, MD Orthopedic Surgery William Mitchell, MD Neurosurgery Heidi Prather, DO Physical Medicine & Rehabilitation William C. Watters, III, MD Orthopedic Surgery This content of this document should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution. North American Spine Society 3 Appropriate Use Criteria for Cervical Fusion Literature Review Group Jamie Baisden, MD Neurosurgery Christopher M. Bono, MD Orthopedic Surgery Charles A. Reitman, MD Orthopedic Surgery Alok D. Sharan, MD Orthopedic Surgery Christopher J. Standaert, MD Physical Medicine & Rehabilitation William Tontz, MD Orthopedic Surgery Rater Group Paul A. Anderson, MD Orthopedic Surgery Sanford E. Emery, MD, MBA Orthopedic Surgery Christopher G. Furey, MD Orthopedic Surgery James Harrop, MD Neurosurgery Christopher P. Kauffman, MD Orthopedic Surgery Mark A. Lorenz, MD Orthopedic Surgery Raj D. Rao, MD Orthopedic Surgery K. Daniel Riew, MD Orthopedic Surgery Jerome Schofferman, MD Pain Management & Medicine Jeffrey M. Spivak, MD Orthopedic Surgery William J. Sullivan, MD Physical Medicine & Rehabilitation Jeffrey C. Wang, MD Orthopedic Surgery William C. Welch, MD Neurosurgery David A. Wong, MD, MS Orthopedic Surgery This content of this document should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution. North American Spine Society 4 Appropriate Use Criteria for Cervical Fusion Financial Statement These appropriate use criteria were developed and funded in their entirety by the North American Spine Society (NASS). All participating authors have disclosed potential conflicts of interest consistent with NASS’ disclosure policy. Disclosures can be found in the document appendix. Comments Comments regarding this document may be submitted to the North American Spine Society and will be considered in development of future revisions of the work. North American Spine Society Appropriate Use Criteria for Cervical Fusion Copyright © 2013 North American Spine Society 7075 Veterans Boulevard Burr Ridge, IL 60527 USA 630.230.3600 www.spine.org 1-929988-34-6 This content of this document should not be construed as including all proper methods of care or excluding other acceptable methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding any specific procedure or treatment is to be made by the physician and patient in light of all circumstances presented by the patient and the needs and resources particular to the locality or institution. North American Spine Society 5 Appropriate Use Criteria for Cervical Fusion Table of Contents CERVICAL FUSION APPROPRIATE USE CRITERIA WORK GROUPS ..................................... 2 FINANCIAL STATEMENT .............................................................................................. 4 COMMENTS ............................................................................................................... 4 INTRODUCTION ......................................................................................................... 6 WHY AUCS? ............................................................................................................................................................. 7 OBJECTIVE ................................................................................................................................................................. 7 REVISION ................................................................................................................................................................... 8 INTENDED USERS ...................................................................................................................................................... 8 PATIENT POPULATION .............................................................................................................................................. 8 METHODOLOGY.......................................................................................................... 8 DEFINITIONS ........................................................................................................................................................... 11 ABBREVIATIONS ...................................................................................................................................................... 12 ASSUMPTIONS ......................................................................................................................................................... 12 ORGANIZATION AND CONSIDERATIONS ............................................................................................................... 13 OUTLINE OF SCENARIO CHAPTERS-MATRIX COMPONENTS ........................................... 14 EXECUTIVE SUMMARY .............................................................................................. 16 SECTION I ......................................................................................................................................................... 31 SECTION II ........................................................................................................................................................ 33 SECTION III ....................................................................................................................................................... 37 SECTION IV ...................................................................................................................................................... 40 SECTION V ........................................................................................................................................................ 44 SECTION VI ...................................................................................................................................................... 57 SECTION VII ..................................................................................................................................................... 67 SECTION VIII .................................................................................................................................................... 79 SECTION IX ....................................................................................................................................................... 80 APPENDIX ............................................................................................................... 82 AUTHOR DISCLOSURES ........................................................................................................................................... 82 LITERATURE SEARCH PARAMETERS ....................................................................................................................... 89 CLINICAL GUIDELINES SEARCH PARAMETERS ...................................................................................................... 91 REFERENCES ............................................................................................................................................................ 91 EVIDENTIARY TABLES ............................................................................................................................................. 94 RAW RATING SCORES ........................................................................................................................................... 112 This content of this document should not be construed as including all proper methods of
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