BlueCross BlueShield of Tennessee Medical Policy Manual

Facet Arthroplasty


Facet arthroplasty refers to the implantation of a spinal prosthesis to restore posterior element structure and function as an adjunct to neural decompression. This procedure is proposed as an alternative to posterior spinal fusion for individuals with facet arthrosis, spinal stenosis, and spondylolisthesis.  The objective of facet arthroplasty is to stabilize the spine while retaining normal intervertebral motion of the surgically removed segment following neural decompression. It is proposed that facet arthroplasty should also maintain the normal biomechanics of the adjacent vertebrae. If normal motion patterns are achieved by artificial joints in the spine, the risk of adjacent-level degeneration thought to be associated with fusion may be mitigated. No facet arthroplasty devices are approved by the U.S. Food and Drug Administration (FDA) at this time.




BlueCross BlueShield Association. Evidence Positioning System. (5:2019). Facet arthroplasty (7.01.120). Retrieved September 5, 2019 from (3 articles and/or guideline reviewed)

Dahl, M., & Freeman, A. (2016). Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device. Spine Journal, 16 (4), 531-539. Abstract retrieved December 12, 2016 from PubMed database.

Sjovold, S., Zhu, Q., Bowden, A., Larson, C., de Bakker, P., Villarraga, M., et al. (2012). Biomechanical evaluation of the total facet arthroplasty system (TFAS): loading as compared to a rigid posterior instrumentation system. European Spine Journal, 2012, 21, 1660-1673. (Level 4 evidence)


MOST RECENT REVIEW DATE:  10/10/2019    


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