Evidence map›Paper›PMID 40533267›Full record

ArticleInternational journal of spine surgery2025

ISASS Recommendations and Coverage Criteria for Bone-Anchored Annular Defect Closure Following Lumbar Discectomy: Coverage Indications, Limitations, and/or Medical Necessity-An ISASS 2025 Policy Update on the Use of Bone-Anchored Annular Closure to Prevent Reherniation in High-Risk Lumbar Discectomy Patients.

Morgan P Lorio, Richard A Kube, John Ratliff, Anthony DiGiorgio, David A Essig, Kris Radcliff, Kai-Uwe Lewandrowski, Jon E Block

Abstract read
In one paragraph

Article in International journal of spine surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Morgan P LorioDepartment of Orthopedics, Orlando College of Osteopathic Medicine, Winter Garden, FL, USA.
Richard A KubePrairie Spine and Pain Institute, Peoria, IL, USA.
John RatliffDepartment of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, CA, USA.
Anthony DiGiorgioDepartment of Neurosurgery, University of California, San Francisco, CA, USA.
David A EssigNorthwell Health Physician Partners, Great Neck, NY, USA.
Kris RadcliffThe Spinal DISC Center, Somers Point, NJ, USA.
Kai-Uwe LewandrowskiCenter for Advanced Spine Care of Southern Arizona, Tucson, AZ, USA.
Jon E BlockIndependent Consultant, San Francisco, CA, USA jb@drjonblock.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with symptomatic lumbar disc herniation with radiculopathy where there is a large residual annular defect following discectomy are at greater risk of reherniation with symptom recurrence and revision surgery. These patients may benefit from primary annular repair. In 2019, the International Society for the Advancement of Spine Surgery published clinical guidelines supporting the use of bone-anchored annular closure in patients with large annular defects who are at greater risk for recurrent disc herniation. This 2025 update is provided to (1) summarize the current, increased clinical evidence for bone-anchored annular closure with greater follow-up durations and (2) update guidance for coding in light of new diagnostic and upcoming current procedural terminology codes. Based on accumulating clinical evidence, the International Society for the Advancement of Spine Surgery reiterates its position that in patients with symptomatic lumbar disc herniation with radiculopathy undergoing primary discectomy with large (≥6 mm wide) annular defects, bone-anchored annular closure may be used to sustain the treatment benefits of discectomy.

Indexed as

annular defectbone-anchored annular closurediscectomylumbarrecurrent disc herniation

Identifiers

PMID40533267
PMCPMC12570054

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.