What the review is about
Spinal fusion cages and plates are used in some types of spinal fusion surgery.
In January 2026, we published clarified groupings’ descriptors and definitions for PL grouping 13.10.01 – Interbody Fusion Cage, Integral Fixation, 13.10.02 – Interbody Fusion Cage, No Integral Fixation, 13.05.01 – Plate, Integral Fixation and 13.05.02 – Plate, No Integral Fixation.
In 2024, we asked stakeholders for feedback on the clarified groupings. During consultation, some stakeholders claimed integral fixation cages offer superior clinical benefits compared to no integral fixation and should be appropriately reimbursed to reflect this. Other stakeholders supported the clarity in the proposed definitions.
In 2025, the Spinal and Neurosurgical Expert Clinical Advisory Group (SNECAG) recommended we undertake a post-listing review of devices in groups 13.10.01 and 13.10.02 to determine if the current benefits payable for spinal cages reflect their cost-effectiveness. The review will also include consideration of spinal plates, listed in 13.05.01 and 13.05.02.
The devices in scope of the review are:
- 13.10.01.01 – Fusion Cage – Interbody, Integral Fixation – Cervical
- 13.10.01.02 – Fusion Cage – Interbody, Integral Fixation – ThoracoLumbar/Lumbar
- 13.10.02.01 – Fusion Cage – Interbody, No Integral Fixation – Cervical
- 13.10.02.02 – Fusion Cage – Interbody, No Integral Fixation – ThoracoLumbar/Lumbar)
- 13.05.01.01 – Plate – Integral Fixation – Cervical
- 13.05.01.02 – Plate – Integral Fixation – ThoracoLumbar/Lumbar/Lumbosacral
- 13.05.02.01 – Plate – No Integral Fixation – Cervical
- 13.05.02.02 – Plate – No Integral Fixation – ThoracoLumbar
The review process
The review will follow the process outlined in the post-listing review framework, exploring the following:
- Does integral fixation, compared to no integral fixation, impact clinical outcomes?
- What mix of individual devices/components are used for integral fixation versus no integral fixation?
- Based on published cost-effectiveness studies, what is the comparative cost effectiveness of integral fixation compared to no integral fixation?
- Are the benefits and/or groupings of the devices appropriate?
Timeline
- January – March 2026 – Stakeholder consultation.
- June 2026 – Draft report.
- July – August 2026 – Stakeholder consultation on draft report.
- November 2026 – Final report.
- December 2026 – Present final report to MDHTAC for advice.
Result of the review
This review is ongoing. We will release the outcome when the review is complete.
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