0171T Insertion of posterior spinous process distraction device (including necessary removal of bone or ligament for insertion and imaging guidance), lumbar; single level

Name of the Procedure:

Insertion of Posterior Spinous Process Distraction Device (Including Necessary Removal of Bone or Ligament for Insertion and Imaging Guidance), Lumbar; Single Level

Summary

This procedure involves inserting a special device between the spinous processes of the vertebrae in the lower back to help relieve pressure on the spinal nerves. It includes removing some bone or ligament tissue to make space for the device and uses imaging technology for precise placement.

Purpose

This procedure is designed to treat lumbar spinal stenosis—a condition where the spinal canal narrows, causing pressure on the spinal cord and nerves. The goal is to alleviate pain, improve mobility, and enhance quality of life.

Indications

• Chronic lower back pain
• Radiating leg pain (sciatica)
• Numbness or weakness in the legs
• Symptoms not responding to conservative treatments like physical therapy or medication

Preparation

• Fast for a specific period before the procedure, as instructed by your healthcare provider.
• Adjust or stop certain medications, such as blood thinners, under medical advice.
• Pre-procedure imaging tests like MRI or CT scans to guide the placement of the device.

Procedure Description

1. Administer anesthesia (usually general or spinal).
2. Make a small incision in the lower back.
3. Remove a small amount of bone or ligament tissue to create space for the device.
4. Insert the distraction device between the spinous processes.
5. Use imaging guidance (like X-ray or fluoroscopy) to ensure correct placement.
6. Close the incision with sutures or staples.

Duration

Typically lasts between 1 to 2 hours.

Setting

Performed in a hospital or surgical center under sterile conditions.

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurse
• Radiologic technologist (for imaging guidance)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Nerve injury or damage
• Device malfunction or displacement
• Persistent symptoms or no improvement

Benefits

• Relief from chronic lower back and leg pain
• Improved mobility and function
• Reduced need for pain medications
• Faster recovery compared to more invasive spine surgeries

Recovery

• Hospital stay of 1-2 days, though some patients may go home the same day.
• Post-procedure care includes wound care and pain management.
• Avoid heavy lifting and strenuous activities for several weeks.
• Physical therapy may be recommended.
• Follow-up appointments to monitor recovery and device placement.

Alternatives

• Physical therapy and exercise programs
• Medication management (pain relievers, anti-inflammatory drugs)
• Epidural steroid injections
• More invasive surgeries like laminectomy or spinal fusion

Patient Experience

• During the procedure, you won't feel pain due to anesthesia.
• Afterward, expect some soreness and discomfort at the incision site.
• Pain can be managed with prescribed medications and ice packs.
• Gradual return to normal activities with restrictions as recommended by your surgeon.