Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Computer-assisted Musculoskeletal Surgical Navigational Orthopedic Procedure (With Image-Guidance Based on Fluoroscopic Images)
Summary
This advanced orthopedic procedure uses real-time fluoroscopic imaging and computer navigation to enhance the accuracy and precision of surgical interventions on bones and joints.
Purpose
This procedure is designed to address complex musculoskeletal conditions by providing enhanced visualization and guidance to the surgeon. Its goals are to improve surgical outcomes, reduce recovery time, and minimize the risk of complications.
Indications
- Severe arthritis
- Complex fractures
- Bone deformities
- Spinal disorders
- Patients with previous unsuccessful orthopedic surgeries
- Need for precise placement of orthopedic implants
Preparation
- Fasting may be required several hours before the procedure.
- Adjustments to medication, especially blood thinners, may be necessary.
- Pre-operative imaging tests, such as X-rays or MRIs, will be conducted.
- A thorough medical assessment to ensure the patient's fitness for surgery.
Procedure Description
- The patient is positioned appropriately on the operating table.
- Anesthesia is administered, which may be general or regional based on the procedure.
- Small incisions are made to insert surgical instruments.
- Fluoroscopic cameras provide real-time images, which are fed into a computer system.
- The computer assists by mapping the surgical site and guiding the surgeon's instruments accurately.
- The surgeon performs the required orthopedic corrections or implantations.
- The incisions are closed, and the area is dressed.
Duration
The procedure typically takes between 2 to 4 hours, depending on the complexity of the case.
Setting
This procedure is typically performed in a hospital or a specialized surgical center equipped with the necessary imaging and navigation technology.
Personnel
- Orthopedic Surgeon
- Anesthesiologist
- Surgical Nurses
- Radiologic Technologist
- Surgical Technologist
Risks and Complications
- Infection at the surgical site
- Blood clots
- Nerve or blood vessel damage
- Complications related to anesthesia
- Hardware failure or misplacement
- Longer recovery time if complications occur
Benefits
- Higher accuracy in surgical interventions
- Reduced likelihood of repeat surgeries
- Enhanced outcomes and function of the affected area
- Quicker recovery times with fewer complications
- Improved patient satisfaction due to better surgical precision
Recovery
- Initial recovery in the post-anesthesia care unit (PACU) for close monitoring
- Possible use of pain management techniques, including medications and ice therapy
- Physical therapy may be required to restore function and strength
- Follow-up appointments for monitoring the progress of healing
- Patients may need to restrict activity and avoid putting weight on the affected area for several weeks
Alternatives
- Traditional open surgery without computer guidance
- Minimally invasive orthopedic surgery (without imaging guidance)
- Physical therapy and medication for pain management (non-surgical)
- Each alternative has varying pros and cons in terms of precision, recovery time, and potential outcomes.
Patient Experience
- Patients will be under anesthesia during the procedure and thus should not feel pain.
- Post-operatively, they may experience discomfort, but pain management strategies will be in place.
- Swelling, bruising, and temporary limited mobility in the operated area are common.
- Emotional support and adequate patient education on post-operative care can contribute to a smoother recovery process.