22328 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (List separately in addition to code for primary proce

Name of the Procedure:

Open Treatment and/or Reduction of Vertebral Fracture(s) and/or Dislocation(s), Posterior Approach, Additional Segment (List separately in addition to code for primary procedure)

Summary

This surgical procedure involves accessing the spine from the back (posterior approach) to treat additional fractured vertebrae or dislocated segments. It is performed in conjunction with a primary spinal surgery to address multiple vertebral fractures or dislocations.

Purpose

This procedure is performed to stabilize the spine, reduce pain, and prevent further damage to the spinal cord and nerves. The goal is to correct deformities in the spine arising from fractures or dislocations and restore proper alignment and function.

Indications

• Multiple vertebral fractures or spinal dislocations that cannot be managed through non-surgical methods.
• Severe back pain, neurological deficits, or signs of spinal instability.
• Conditions such as trauma, osteoporosis, or cancer that have led to fractures or dislocations.

Preparation

• Fasting typically required 8-12 hours before surgery.
• Medication adjustments as directed by the healthcare provider.
• Preoperative imaging (X-rays, CT scans, or MRIs) to assess the extent of the damage.
• Blood tests and physical examination to ensure the patient is fit for surgery.

Procedure Description

1. The patient is positioned face down (prone) on the operating table.
2. General anesthesia is administered.
3. An incision is made along the midline of the back to expose the affected vertebrae.
4. The surgeon uses specialized instruments to realign the fractured or dislocated segments.
5. Additional hardware (screws, rods) may be inserted to stabilize the spine.
6. For each additional vertebra or dislocated segment, the procedure is repeated.
7. Once stabilization is achieved, the surgical site is closed with sutures or staples.

Duration

The procedure can take several hours, depending on the number of vertebrae/dislocated segments treated and the complexity of the case.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Orthopedic surgeon or neurosurgeon.
• Surgical nurses.
• Anesthesiologist.
• Surgical technologists.

Risks and Complications

• Infection.
• Bleeding.
• Nerve damage.
• Spinal fluid leakage.
• Failure to achieve desired spinal stability.
• Anesthesia-related risks.

Benefits

• Reduced pain and improved spinal stability.
• Prevention of further spinal cord or nerve damage.
• Enhanced mobility and quality of life.
• Benefits may be realized immediately post-surgery or gradually over several weeks.

Recovery

• Hospital stay of several days for monitoring and pain management.
• Limited physical activity; use of a brace may be required.
• Follow-up appointments to monitor healing and spinal alignment.
• Physical therapy to regain strength and mobility.

Alternatives

• Non-surgical treatments: bracing, physical therapy, pain management.
• Minimally invasive spinal surgery.
• Pros: Non-surgical options have fewer immediate risks.
• Cons: May not be effective for severe cases requiring structural correction.

Patient Experience

• The patient may experience post-surgical pain, managed with medications.
• Discomfort from limited mobility and use of a brace.
• Gradual improvement in pain and mobility over the recovery period.
• Regular follow-up is crucial to ensure proper healing and alignment.