{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T19:06:16Z","timestamp":1777057576145,"version":"3.51.4"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Providence\u2122 Medical Systems"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: The traditional open midline posterior cervical spine fusion procedure has several shortcomings. It can cause soft tissue damage, muscle atrophy, compromise of the lateral masses and painful prominent posterior cervical instrumentation or spinous process if there is dehiscence of the fascia. Additionally, patients frequently experience the rapid development of adjacent segment disease, which can result in the reemergence of debilitating pain and functional impairment. Clinical relevance: Tissue-sparing posterior cervical fusion is an alternative method for treating patients with symptomatic cervical degenerative disc disease. However, widespread clinical adoption has been challenged by ambiguity, misunderstandings and misinterpretations regarding appropriate procedural reimbursement coding. Technological advancement: The tissue-sparing posterior cervical fusion procedure was approved by the US Food and Drug Administration (FDA) in 2018 (CORUS\u2122 Spinal System and CAVUX\u00ae Facet Fixation System (CORUS\/CAVUX); Providence\u2122 Medical Technology). This technique addresses the concerns with traditional spine fusion methods by achieving the stability and outcomes of posterior cervical fusion without the morbidity associated with significant muscle stripping in the traditional approach. This technology uses specialized implants and instrumentation to perform all of the steps required to facilitate bone fusion and provide stability while minimizing tissue disruption. The technique involves extensive bone preparation for fusion and placement of specialized stabilization implants that span the facet joint, promoting natural bone growth and fusion while reducing the need for extensive exposure. This procedure provides an effective, less invasive solution for patients with cervical degenerative disc disease. Reimbursement and coding clarity: The article provides a comprehensive rationale for appropriate reimbursement coding for tissue-sparing posterior cervical fusion. This is a critical aspect for the adoption and accessibility of medical technologies. This information is crucial for practitioners and healthcare administrators, ensuring that innovative procedures are accurately coded and reimbursed. Procedural details and clinical evidence: By detailing the procedural steps, instruments used and the physiological basis for the procedure, this article serves as a valuable educational resource for spine surgeons and payers to appropriately code for this procedure. Conclusions: The description of work for CORUS\/CAVUX is equivalent to the current surgical standard of lateral mass screw fixation with decortication and onlay posterior grafting to facilitate posterior fusion. Thus, it is recommended that CPT codes 22600\/22840 be used, as they best reflect the surgical approach, instrumentation, decortication, posterior cervical fusion and bone grafting procedures.<\/jats:p>","DOI":"10.3390\/jpm14080837","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T15:04:24Z","timestamp":1723129464000},"page":"837","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Implementation of Tissue-Sparing Posterior Cervical Fusion: Addressing Market Access Challenges"],"prefix":"10.3390","volume":"14","author":[{"given":"Morgan P.","family":"Lorio","sequence":"first","affiliation":[{"name":"Advanced Orthopedics, 499 East Central Parkway, Altamonte Springs, FL 32701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierce D.","family":"Nunley","sequence":"additional","affiliation":[{"name":"Spine Institute of Louisiana, 1500 Line Ave, Ste. 200, Shreveport, LA 71101, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua E.","family":"Heller","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University, 909 Walnut Street, Philadelphia, PA 19107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce M.","family":"McCormack","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of California San Francisco, 2320 Sutter Street, Ste. 202, San Francisco, CA 94115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7842-2914","authenticated-orcid":false,"given":"Kai-Uwe","family":"Lewandrowski","sequence":"additional","affiliation":[{"name":"Center for Advanced Spine Care of Southern Arizona, Division Personalized Pain Research and Education, Tucson, AZ 85712, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-8938","authenticated-orcid":false,"given":"Jon E.","family":"Block","sequence":"additional","affiliation":[{"name":"Independent Consultant, 2210 Jackson Street, Ste. 401, San Francisco, CA 94115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s11420-019-09722-x","article-title":"Posterior Fusion for the Subaxial Cervical Spine: A Review of the Major Techniques","volume":"16","author":"Mikhail","year":"2020","journal-title":"HSS J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1097\/00007632-198510000-00006","article-title":"A technique of posterior cervical fusion for instability of the cervical spine","volume":"10","author":"Davey","year":"1985","journal-title":"Spine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1055\/s-0032-1307261","article-title":"Lateral mass fixation in subaxial cervical spine: Anatomic review","volume":"2","author":"Mohamed","year":"2012","journal-title":"Glob. 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