SUBJECT: Washington State HTA Key Questions for Review of Surgery for Symptomatic
Lumbar Radiculopathy
Dear Mr. Morse:
The American Academy of Orthopaedic Surgeons (AAOS), American Association of Neurological Surgeons
(AANS), AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves (DSPN), Congress of
Neurological Surgeons (CNS), International Society for the Advancement of Spine Surgery (ISASS), North
American Spine Society (NASS) and the Washington State Association of Neurological Surgeons (WSANS)
appreciate the opportunity to provide feedback on the draft key questions for consideration of surgery for
symptomatic lumbar radiculopathy.
We have attached a document presenting the consensus views of our organizations on each of the draft key
questions and including a robust review of the relevant literature. We must reiterate our view that spine surgery
seems to have been disproportionately selected as a review topic by the Health Technology Assessment
Program. Collectively, our organizations do not agree with the need to review surgery for symptomatic lumbar
radiculopathy at this time. The surgical treatment of lumbar radiculopathy in patients refractory to nonoperative
measures or with a neurological deficit has been the standard of care for decades. We hope that the review
will be based on the strength of the evidence and availability of care in the state of Washington. Our
organizations are concerned that some past decisions regarding spine care were based on studies conducted
outside the United States and thus not relevant to the population covered by the programs in the purview of the
Washington State Health Care Authority — resulting in fewer effective treatment options for those patients.
Thank you for the opportunity to provide our comments.
Read full letter here
