Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2
CPT4 code
Name of the Procedure:
Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy, and decompression of spinal cord and/or nerve roots; cervical below C2
Summary
This procedure is a type of spine surgery that involves fusing two or more vertebrae in the neck to stabilize the spine. It includes preparing the disc space, removing a damaged disc (discectomy), shaving down bone spurs (osteophytectomy), and relieving pressure on the spinal cord and nerve roots (decompression).
Purpose
Arthrodesis aims to treat severe spinal conditions in the neck, such as degenerative disc disease, spinal instability, or severe disc herniation. The expected outcome is to alleviate pain, improve stability, and prevent further neurological damage.
Indications
- Severe neck pain unresponsive to conservative treatments
- Spinal instability
- Degenerative disc disease
- Herniated cervical disc causing significant nerve compression
- Spinal deformities or other structural issues
Preparation
- Fasting for at least 8 hours before surgery
- Adjusting current medications as instructed by the healthcare provider
- Diagnostic imaging like MRI or CT scans to assess the spine
- Preoperative clearance (e.g., blood tests, EKG)
Procedure Description
- Anesthesia: The patient is placed under general anesthesia.
- Incision: A small incision is made in the front (anterior) of the neck.
- Disc Space Preparation: The surgeon accesses the vertebrae and removes the intervertebral disc (discectomy).
- Osteophytectomy: Bone spurs are carefully shaved down.
- Decompression: The spinal cord and nerve roots are decompressed by removing any impinging bone or disc tissue.
- Fusion: Bone grafts and/or implants are placed in the disc space to facilitate fusion of the vertebrae.
- Closure: The incision is closed with sutures, and a bandage is applied.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity.
Setting
The procedure is performed in a hospital operating room.
Personnel
- Orthopedic or Neurosurgeon
- Surgical Nurse
- Anesthesiologist
- Surgical Technician
- Postoperative Care Team
Risks and Complications
- Infection
- Blood clots
- Nerve damage
- Nonunion or failure of the bones to fuse properly
- Persistent pain or new pain
- Adverse reactions to anesthesia
Benefits
- Pain relief
- Improved spinal stability
- Prevention of further nerve damage
- Enhanced quality of life Benefits can often be realized within weeks to a few months post-surgery.
Recovery
- Pain management with prescribed medications
- Physical therapy starting a few weeks after surgery
- Wearing a neck brace for several weeks
- Avoiding heavy lifting and strenuous activities for 6-12 weeks
- Regular follow-up appointments to monitor healing
Alternatives
- Conservative treatments (physical therapy, medication)
- Minimally invasive spine surgery
- Cervical disc replacement
- Pros and Cons: Conservative treatments might not be effective for severe conditions, and minimally invasive options may not be suitable for all cases.
Patient Experience
- During: The patient will be under general anesthesia and will not feel any pain.
- After: Postoperative pain managed with medication, discomfort from the incision, and possibly a feeling of neck stiffness.
Pain management will include prescribed medications and gradual return to daily activities with advice from the healthcare team.