Annulus Closure After Discectomy

This policy addresses annulus closure after lumbar discectomy and authorizes placement of a bone‑anchored annular closure device (e.g., Barricaid®) as an adjunct at the time of a primary single‑level L4–S1 discectomy to reduce recurrent herniation risk in patients with symptomatic disc extrusion/radiculopathy who have failed conservative therapy and have large annular defects (4–6 mm high by 6–10 mm wide) and adequate disc height (≥5 mm). Coverage is device‑specific and limited to FDA‑approved bone‑anchored implants for primary, single‑level use (not for recurrent or multilevel procedures); evidence is limited/inconsistent, some annular closure technologies remain investigational/not covered, and final coverage is subject to the member’s benefit plan.

"Symptomatic intervertebral disc herniation (disc extrusion) causing nerve root compression presenting with pain, numbness, or weakness"