22585 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure)

Name of the Procedure:

Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace

Summary

Arthrodesis, commonly known as spinal fusion, is a surgical procedure where two or more vertebrae are permanently joined together. The anterior interbody technique involves accessing the spine through the front (anterior) and removing a disc to prepare the space for fusion. This guide specifically addresses the process for additional interspaces.

Purpose

Arthrodesis is utilized to treat severe back pain and spinal instability. The goal is to stabilize the spine, reduce pain, and improve function by fusing the problematic vertebrae together.

Indications

• Chronic back pain not relieved by non-surgical treatments.
• Disc degeneration or herniation.
• Spinal stenosis.
• Spondylolisthesis.
• Spinal fractures.
• Deformities like scoliosis or kyphosis.

Preparation

• Fasting for 8-12 hours before surgery.
• Adjustments to medications (such as blood thinners).
• Pre-operative imaging tests like MRI or CT scans.
• Pre-surgical health evaluations and clearances.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A small incision is made in the front (abdomen).
3. Disc Removal: The affected disc is partially removed (minimal discectomy).
4. Fusion: The space between the vertebrae is prepared using bone grafts or implants.
5. Additional Interspaces: The same steps are repeated for each additional interspace requiring fusion.

Duration

The procedure generally takes between 2 to 5 hours, depending on the number of interspaces involved.

Setting

This procedure is typically performed in a hospital operating room.

Personnel

• Orthopedic or neurosurgeon.
• Surgical nurses.
• Anesthesiologist.
• Operating room technicians.

Risks and Complications

• Infection.
• Bleeding.
• Nerve damage.
• Blood clots.
• Failure of the bones to meld (nonunion).
• Pain at the graft or incision site.

Benefits

• Stability of the spine.
• Reduction or elimination of pain.
• Improved mobility and function.
• Long-term resolution of spinal issues.

Recovery

• Hospital stay of 2-4 days post-surgery.
• Pain management with prescribed medications.
• Physical therapy starting a few weeks post-surgery.
• Avoidance of heavy lifting or strenuous activities for approximately 3-6 months.
• Regular follow-up appointments for monitoring.

Alternatives

• Physical therapy.
• Medications for pain and inflammation.
• Spinal injections.
• Other surgical methods like laminectomy.

Patient Experience

During the procedure, the patient will be under general anesthesia and feel no pain. Post-surgery, there may be discomfort and pain managed by medications. Rehabilitation involves gradually increasing activity levels under medical advice to ensure proper healing and fusion of the spine.