MUA of the hand/fingers after collagenase clostridium histolyticum (Xiaflex) injections for the treatment of Dupuytren's contracture.MUA for injuries of the cruciate ligaments, of multiple joints, for disorders of other body joints (e.g., ankle, elbow, finger, hip, pelvis, toe, and wrist), or for osteoporotic thoracolumbar vertebral compression fracture.In this regard, the Guidelines for Chiropractic Quality Assurance and Practice Parameters published from the proceedings of a consensus conference commissioned by the Congress of Chiropractic State Associations declared that chiropractic involvement in MUA is a new area of special interest that needs further investigation Critical issues such as selection criteria, outcome assessments, and long-term benefits need to be addressed by well-designed studies before this procedure can be considered as an essential part of conservative therapy. This procedure has not been established as either safe or effective for the treatment of musculoskeletal disorders such as neck and back problems. Spinal manipulation under general MUA.The following MUA indications are considered experimental and investigational because the effectiveness of these approaches has not been established (not an all-inclusive list): Chronic, refractory frozen shoulder (adhesive capsulitis) (see Appendix) or.Arthrofibrosis of knee following total knee arthroplasty, knee surgery, or fracture (see Appendix) or.This Clinical Policy Bulletin addresses manipulation under general anesthesia.Īetna considers manipulation under general anesthesia (MUA) medically necessary for the following indications: PMID 21637959.Number: 0204 Table Of Contents Policy Applicable CPT / HCPCS / ICD-10 Codes Background References "Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: A meta-analysis of randomised and non-randomised controlled trials". ^ Han, Shiliang Wan, Shuanglin Ning, Lei Tong, Yongjun Zhang, Jianfeng Fan, Shunwu (2011)."Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures". "Balloon kyphoplasty in the management of vertebral compression fractures: An updated systematic review and meta-analysis". "Balloon Kyphoplasty and Vertebroplasty for Vertebral Compression Fractures". "Calcitonin for treating acute pain of osteoporotic vertebral compression fractures: A systematic review of randomized, controlled trials". ^ "Calcitonin for osteoporotic fractures".The Journal of the American Board of Family Medicine. "Kummel Disease: A Not-So-Rare Complication of Osteoporotic Vertebral Compression Fractures". Philadelphia: Lippincott Williams & Wilkins. Fundamentals of Diagnostic Radiology (3rd ed.). "Rounds 2: Treatment of Metastatic Bone Disease". When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed. In addition, bone density measurement may be performed to evaluate for osteoporosis. Diagnosis Ĭompression fractures are usually diagnosed on spinal radiographs, where a wedge-shaped vertebra may be visible or there may be loss of height of the vertebra. Compression fractures which develop gradually, such as in osteoporosis, may initially not cause any symptoms, but will later often lead to back pain and loss of height. Signs and symptoms Īcute fractures will cause severe back pain. Seen in lateral views in plain x-ray films, compression fractures of the spine characteristically appear as wedge deformities, with greater loss of height anteriorly than posteriorly and intact pedicles in the anteroposterior view. In healthy patients, it is most often seen in individuals suffering extreme vertical shocks, such as ejecting from an ejection seat. This weakening is seen in patients with osteoporosis or osteogenesis imperfecta, lytic lesions from metastatic or primary tumors, or infection. It may be due to trauma or due to a weakening of the vertebra (compare with burst fracture). Example of vertebral compression fracture.Ī compression fracture is a collapse of a vertebra.
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