Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code f
CPT4 code
Name of the Procedure:
Percutaneous Vertebroplasty (Bone Biopsy Included When Performed), 1 Vertebral Body, Unilateral or Bilateral Injection, Inclusive of All Imaging Guidance; Each Additional Cervicothoracic or Lumbosacral Vertebral Body
Summary
Percutaneous vertebroplasty is a minimally invasive procedure used to treat fractured vertebrae in the spine. During this procedure, bone cement is injected into the broken vertebra to stabilize it and relieve pain. The procedure may involve a bone biopsy to diagnose underlying issues, and it includes the use of imaging guidance for accuracy.
Purpose
Medical Condition Addressed:
- Vertebral compression fractures
- Osteoporotic fractures
- Spinal tumors
- Hemangiomas ##### Goals:
- Stabilize the fractured vertebra
- Alleviate pain
- Improve mobility and quality of life
Indications
Symptoms and Conditions:
- Severe back pain not responding to conservative treatments
- Osteoporotic vertebral compression fractures
- Neoplastic spinal lesions or tumors
- Spinal hemangiomas causing pain or vertebral instability ##### Patient Criteria:
- Verified vertebral fracture via imaging studies (e.g., X-ray, MRI, or CT scan)
- Pain localized to the fractured vertebra
- Inability to perform daily activities due to pain
Preparation
Pre-procedure Instructions:
- Fasting (NPO) after midnight prior to the procedure
- Medication adjustments as advised by the healthcare provider (e.g., blood thinners) ##### Diagnostic Tests:
- Imaging studies to identify the location and extent of the fracture
- Preoperative health assessments (e.g., blood tests)
Procedure Description
- Anesthesia: Local anesthesia and possibly mild sedation are administered.
- Access: A needle is inserted into the fractured vertebra through a small incision in the skin.
- Imaging Guidance: Continuous use of fluoroscopy or CT to guide the needle.
- Cement Injection: Medical-grade bone cement is injected into the vertebra to stabilize it.
- Completion: Needle is removed, and a small bandage is placed over the incision site.
- Bone Biopsy (if performed): A sample of the bone is obtained for further analysis.
Tools Used:
- Specialized needles
- Bone cement injection equipment
- Imaging tools (fluoroscopy or CT)
Duration
The procedure typically takes 1 to 2 hours.
Setting
Performed in a hospital or an outpatient surgical center.
Personnel
- Interventional radiologist or spine surgeon
- Radiology technicians
- Nurses
- Anesthesiologist (if moderate sedation is used)
Risks and Complications
Common Risks:
- Infection at the injection site
- Bleeding or bruising
- Leakage of bone cement ##### Rare Risks:
- Nerve damage
- Allergic reactions to medications or materials
- Pulmonary embolism
Benefits
Expected Benefits:
- Significant pain relief
- Increased spinal stability
- Improved ability to perform daily activities ##### Timeline: Pain relief is often experienced within 48 hours post-procedure.
Recovery
Post-procedure Care:
- Immediate observation for a few hours after the procedure
- Pain management as needed ##### Recovery Time:
- Most patients can resume light activities within 24-48 hours. ##### Restrictions:
- Avoid heavy lifting and strenuous activities for at least 6 weeks ##### Follow-Up:
- Regular follow-up appointments to monitor healing and assess for any complications
Alternatives
Other Treatment Options:
- Conservative treatments (e.g., pain medication, physical therapy)
- Spinal fusion surgery ##### Pros and Cons:
- Conservative treatments are less invasive but may not provide immediate relief.
- Spinal fusion is more invasive with a longer recovery time but offers permanent stabilization.
Patient Experience
During the Procedure:
- Mild discomfort or pressure at the injection site
- Sedation may help alleviate anxiety and discomfort ##### After the Procedure:
- Temporary soreness or bruising at the injection site
- Pain relief noticeable within 48 hours ##### Pain Management:
- Oral pain medications as needed for post-procedure discomfort
- Ice packs to reduce swelling and soreness