22100 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical

Name of the Procedure:

Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical.

Summary

This surgical procedure involves removing a part of the back portion of a vertebra (such as the spinous process, lamina, or facet) in the cervical spine to treat a bony lesion. This is typically done at a single vertebral segment.

Purpose

The primary goal is to relieve symptoms and prevent further complications associated with a bony lesion within the cervical spine. This can help reduce pain, improve mobility, and address neurological issues.

Indications

• Persistent neck pain due to a bony lesion.
• Compression of spinal nerves or the spinal cord due to the lesion.
• Failure of conservative treatments (e.g., medication, physical therapy).
• Indicators of spinal instability or progression of the lesion.

Preparation

• Preoperative assessment including physical examination and imaging studies (X-rays, MRI, or CT scans).
• Fasting for at least 8 hours prior to the procedure.
• Adjustments to current medications as per doctor’s instructions.
• Possible blood tests to assess general health.

Procedure Description

1. Anesthesia: The patient is given general anesthesia to ensure they are asleep and pain-free.
2. Positioning: The patient is placed in a prone (lying face down) position.
3. Incision: A small incision is made in the skin overlying the affected vertebra.
4. Exposure: Muscles and tissues are gently moved aside to expose the vertebra.
5. Excision: Using surgical instruments, part of the spinous process, lamina, or facet is carefully removed.
6. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and specifics of the lesion.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic or neurosurgeon.
• Anesthesiologist.
• Surgical nurses and technician.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Damage to nearby nerves or spinal cord.
• Postoperative pain or discomfort.
• Potential for spinal instability.
• Need for additional surgery if complications arise.

Benefits

• Relief from neck pain.
• Reduction of neurological symptoms (e.g., numbness, weakness).
• Potential prevention of further spinal damage.
• Improved quality of life and range of motion.

Recovery

• Initial hospital stay of 1 to 2 days for monitoring.
• Pain management with prescribed medications.
• Physical therapy may be recommended to aid recovery.
• Instructions may include activity restrictions for several weeks.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Conservative treatments (e.g., physical therapy, medications).
• Spinal injections (e.g., corticosteroids).
• More invasive surgeries, such as spinal fusion, if instability is present.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, patients may experience some pain and discomfort at the incision site, which can be managed with pain medications. Physical therapy may be needed to regain full mobility. Full recovery can take several weeks to months, depending on individual healing rates and adherence to post-operative care instructions.