22103 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure)

Name of the Procedure:

Partial Excision of Posterior Vertebral Component (e.g., spinous process, lamina, or facet) for Intrinsic Bony Lesion, Single Vertebral Segment; Each Additional Segment

Summary

This surgical procedure involves the partial removal of a part of the vertebra, such as the spinous process, lamina, or facet, to treat a bone lesion affecting the spine. The surgery can be extended to include additional vertebral segments if needed.

Purpose

The procedure addresses intrinsic bony lesions of the spine, potentially caused by tumors, cysts, or other abnormal growths. The goal is to remove the lesion, relieve symptoms such as pain or neurological deficits, and prevent further spinal damage.

Indications

• Presence of a bony lesion in the posterior vertebra
• Symptoms such as chronic pain, nerve compression, or neurological deficits
• Diagnostic imaging confirming the lesion

Preparation

• Fasting typically required overnight before the procedure
• Adjustment of medications as instructed by the surgeon
• Pre-procedure assessments such as MRI or CT scans to locate the lesion accurately
• Blood tests to assess general health and surgical readiness

Procedure Description

• Anesthesia is administered to ensure the patient is pain-free; general anesthesia is typically used.
• The patient is positioned to provide optimal access to the affected vertebra.
• An incision is made over the affected vertebral segment.
• Surgical instruments are used to remove the targeted posterior vertebral component(s) and the lesion.
• The surrounding structures are carefully preserved.
• The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and number of segments involved.

Setting

The procedure is performed in a hospital, usually in a specialized surgical suite.

Personnel

• Orthopedic or neurosurgeon
• Surgical nurse
• Anesthesiologist
• Surgical technologist

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Spinal instability or deformity
• Neurological damage or persistent pain
• Reoperation if the lesion recurs

Benefits

• Relief from pain and other symptoms caused by the lesion
• Improved neurological function if nerve compression is alleviated
• Prevention of further spinal issues
• Benefits are typically noticed soon after the recovery period

Recovery

• Post-procedure care includes pain management, physical therapy, and monitoring for complications.
• Hospital stay may last a few days.
• Full recovery can take several weeks to months, with follow-up appointments to monitor progress.

Alternatives

• Observation and regular monitoring with imaging
• Radiation or chemotherapy for malignant lesions
• Less invasive surgical options like percutaneous biopsy or needle aspiration
• Conservative treatments like medication and physical therapy

Patient Experience

• Patients may experience discomfort or pain following the procedure, which is managed with medications.
• Physical therapy may be required to regain strength and mobility.
• Most patients can expect gradual improvement in symptoms and quality of life as they recover.