Application 1099
Lumbar Non-fusion Posterior Stabilisation Devices
Lumbar Non-fusion Posterior Stabilisation Devices
Application No. | 1099 |
| Application Name | Lumbar Non-fusion Posterior Stabilisation Devices |
| Advisory Panels | Professor Ken Thomson (Chair and MSAC member) Dr David Wood (MSAC member) Ms Susan Liew (Australian Orthopaedic Association nominee) Dr Ros Taylor (Royal Australian College of General Practitioners nominee) Ms Robin Toohey (Consumers' Health Forum of Australia nominee) Mr Ian McPhee (Australian Orthopaedic Association nominee) Mr Quentin Malone (Royal Australia College of Surgeons nominee) |
| Date Received by MSAC Secretariat | May 2005 |
| Stage 1 - Eligibility | Eligible |
| Stage 2 - Assessment | Completed |
| Stage 3 - Formulation of Advice to the Minister | This assessment was considered by the MSAC at the 25 May 2007 meeting. MSAC has considered safety, effectiveness and cost-effectiveness for a pedicle screw device (Dynesys) and interspinous spacer devices compared with laminectomy with and without conventional spinal fusion. Pedicle screw device (Dynesys) Based on the limited evidence available for this device, MSAC finds that the Dynesys: is as safe as laminectomy with spinal fusion, noting that although there appears to be less blood loss with the use of Dynesys, there is a slightly higher incidence of loosening of the pedicle screws; is no more effective in selected cases than laminectomy and fusion, and requires almost the same surgical exposure; and is less cost-effective than laminectomy without fusion, and as cost-effective as laminectomy and spinal fusion. MSAC recommends that there is insufficient evidence to recommend a change in public funding arrangements for Dynesys at this time. Interspinous spacers (X STOP, Wallis, Coflex, DIAM.) Based on the limited evidence available for these devices, MSAC finds interspinous spacer devices: are as safe as the conventional operations (if the devices were placed without laminectomy the risks and surgical exposure would be less than for conventional laminectomy); may be as effective in selected cases as laminectomy and fusion and may be associated with a better outcome in patients with limited or localised (single level) disc disease; and may be as cost-effective as laminectomy without fusion and more cost-effective than laminectomy and spinal fusion. MSAC recommends that there is insufficient evidence to recommend a change in the public funding arrangements for interspinous devices at this time. |
| Stage 4 - Decision | Accepted by the Minister for Health and Ageing on 21 May 2008. |
| Stage 5 - Implementation |  |
