1509 – Annular Closure using the Barricaid® mesh prosthesis after discectomy

New MBS item.

Towards the end of a spinal discectomy procedure, once the herniated disc material is removed, and confirmation of the annular defect is within indicated size, the Barricaid® mesh is placed on the inner surface of the disc annulus using fluoroscopic guidance and secured to the surrounding vertebral bone with the titanium anchor. The mesh remains within the posterior intervertebral space to occlude the opening created during discectomy. Placement of the mesh takes an additional 10 to 15 minutes just prior to wound closure in a surgery that takes approximately 2 hours.

The Barricaid® prosthesis (Intrinsic Therapeutics, Massachusetts, USA) is a small piece of flexible polymer mesh composed of multiple layers of non-degrading polyethylene terephthalate fibres attached to a titanium bone anchor. The mesh, which contains a platinum-iridium marker that makes it visible on x-ray images, comes in various widths (8, 10 and 12mm) is preloaded in a single-use delivery system.

Type: Therapeutic

Patients who suffer from a herniated lumbar intervertebral disc would most benefit from a Barricaid® annular closure prosthesis that meet the following characteristics:

• primary, medio-lateral disc herniation at the L1 to S1 level (bulging of the disc between the first lumbar and first sacral vertebrae);
• a disc height of 5 mm; and,
• intraoperative confirmation of an annular defect that is between 4mm-6mm in height and between 5mm and 12mm in width
• recurrent disc prolapse.

• PASC meeting: -
• ESC meeting: -
• MSAC meeting: -