CMM-603: Posterior Cervical Decompression (Laminectomy/ Hemilaminectomy/ Laminoplasty) Guidelines

Posterior cervical decompression (laminectomy/hemilaminectomy/laminoplasty) is medically necessary for radiculopathy or myelopathy only when MRI/CT demonstrates neural or cord compression concordant with documented required subjective and objective findings — radiculopathy also requires failure of at least two specified conservative treatments (6 weeks each) and absence of unmanaged significant behavioral health disorders, and repeat surgery requires >12 weeks since the prior procedure. Urgent/emergent indications (e.g., traumatic fracture/dislocation with neural compression, central cord syndrome, progressive deficit, severe motor loss, incontinence, epidural hematoma, infection, tumor) waive conservative/behavioral requirements, while procedures for non‑concordant symptoms, annular tears, asymptomatic disc bulges, degenerative disc disease, and percutaneous or posterior endoscopic cervical techniques are not medically necessary or investigational.

"Urgent/Emergent conditions for posterior cervical decompression include ANY of the following: Acute/unstable traumatic spinal fractures or dislocations with neural compression; Central cord syndrom..."