General Guideline Principles for Spinal Fusion
for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Elbow Injury.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Spinal Fusion of Therapeutic Procedures: Operative

There is no mention of lumbar fusion on the list of pre-approved operations. When a provider wants to carry out one of these operations, they must first get pre-approval from the carrier.

Spinal Fusion

1. Spinal Fusion is recommended clinically appropriate in a subset of patients.

   Spinal Fusion is recommended when concurrent spondylolisthesis has been established as a therapy for spinal stenosis. The degree of instability, concomitant deformities/body habitus, patient age, bone quality, and medical comorbidities, among other considerations, should all be taken into account when the surgeon and patient make the decision about instrumentation.

   For spinal stenosis without spondylolisthesis, instability, surgical instability, and facetectomy of more than 50% of the facet joints, lumbar fusion is not advised.

   Indications: All of the following requirements must be met: 1) neurogenic claudication, which causes leg pain or numbness when standing or moving; 2) MRI or CT/myelogram imaging results that show the compressed nerve roots are compatible with the neurological symptoms; 3. Failure to respond to proper conservative treatment over a minimum of six to eight weeks, which may or may not include an epidural steroid injection.

    

2. Spinal Fusion is recommended as a successful method of treating isthmic spondylolisthesis.

    

3. Spinal Fusion is recommended as a successful treatment for spondylolisthesis with degenerative changes.

    

4. Spinal Fusion with Third Discectomy

   Spinal Fusion with Third Discectomy is recommended A fusion procedure may be considered at the time of the third discectomy in some individuals who need a third lumbar discectomy at the same level.

   Indications: Meeting indications for a third discectomy on the same disc.

   Spinal Fusion with Third Discectomy

   Spinal Fusion with Third Discectomy is recommended The need for a third discectomy on the same disc is met. It is advised as a treatment for Degenerative Disc Disease, “Discogenic Back Pain,” or “Black Disc Disease” in a subset of individuals for whom non-surgical treatments has not been successful in symptom relief and functional improvement.

   The patient should be fully aware that this kind of procedure may not lead to any improvement and is unlikely to entirely relieve symptoms. A comprehensive functional rehabilitation programme should be tried first, if available.

    

5. Spinal Fusion with Third Discectomy is not recommended – as a treatment for patients who have lumbar discectomy-related non-acute back pain or for patients who have radiculopathy from herniated nucleus pulposus (disc herniation).

What our office can do if you have workers compensation Elbow Injury

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.