InSpan® Spinous Process Plate System is a medically necessary treatment for those patients who meet the below selection criteria:

• Back/leg/buttocks/groin pain that impacts a patient’s quality of life or limits activities of

• Absence of generalized pain behavior or pain disorders,

• Failed at least 6 months of non-operative treatment including medication, activity

• modification, therapy.

• Diagnostic imaging studies (Xray, CT and/or MRI scans) showing:

  • Spondylolisthesis

  • Trauma (fracture or dislocation)

  • Tumor

  • Degenerative disc disease.

  • Spinal Stenosis

  • Facet joint abnormalities* (See below)

*Patients with back pain also tend to have associated facet joint abnormalities including, but not limited to, facet hypertrophy and osteophytes, facet reactive changes, facet tropism, facet fluid and cysts which can lead to compression/encroachment (subarticular, neuroforaminal and lateral recess stenosis).

*Patients with back pain are also prone to a high incidence of facet tropism. Facet tropism is defined as angular asymmetry between the left and right facet joint orientation greater than 6 degrees. Facet tropism can be characterized based on the degree of asymmetry where mild (between 6 and 10 degrees), moderate (10 to 16 degrees) and severe (greater than 16 degrees). Patients with facet tropism are at risk for facet instability and developing degenerative spondylolisthesis.