Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Arthrodesis, Posterior Interbody Technique (including laminectomy and/or discectomy to prepare interspace, other than for decompression), Single Interspace; Each Additional Interspace (List separately in addition to code for primary procedure)
Summary
Arthrodesis, commonly known as spinal fusion, is a surgical procedure aimed at joining two or more vertebrae in the spine. This specific technique involves a posterior interbody approach, where the surgeon accesses the spine from the back. The procedure may include removing portions of the vertebrae (laminectomy) or intervertebral discs (discectomy) to prepare the area for fusion.
Purpose
The procedure addresses conditions such as severe spinal instability, degenerative disc disease, or spinal deformities. The goal is to stabilize the spine, reduce pain, and prevent further degeneration or nerve damage.
Indications
- Chronic back pain not responsive to conservative treatments
- Spinal instability or deformity
- Degenerative disc disease
- Spondylolisthesis
- Recurrent herniated discs
- Fractures
Preparation
- Fasting typically required for 8-12 hours before surgery
- Adjustments to medications as instructed by the healthcare provider
- Preoperative imaging tests such as X-rays, MRI, or CT scans
- Routine blood tests and health assessments
Procedure Description
- The patient is placed under general anesthesia.
- An incision is made in the back to access the spine.
- A laminectomy (removal of part of the vertebral bone) or discectomy (removal of disc material) is performed to prepare the interspace.
- Bone graft material or bone graft substitutes are placed between the vertebrae.
- Metal screws, rods, or plates may be used to stabilize the spine while the bone graft heals.
- The incision is closed with sutures or staples.
Duration
The procedure typically takes 2-5 hours, depending on the number of interspaces to be fused and the complexity of the condition.
Setting
Arthrodesis is performed in a hospital or surgical center equipped for spinal surgeries.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
- Radiologist (if imaging guidance is required)
Risks and Complications
- Infection
- Blood clots
- Nerve damage
- Nonunion (failure of the bone to fuse)
- Hardware complications (e.g., breaking or moving)
- Pain at the graft site
Benefits
- Stabilization of the spine
- Reduction of pain
- Improvement in function and mobility
- Prevention of further spinal degeneration
Recovery
- Hospital stay of 2-4 days
- Limited activity for several weeks; avoid heavy lifting, bending, and twisting
- Pain management typically involves medications
- Physical therapy may begin several weeks post-operation
- Full recovery can take several months to a year
Alternatives
- Conservative treatments: physical therapy, medications, spinal injections
- Other surgical options: artificial disc replacement, anterior interbody fusion
- Each alternative has its own set of risks and benefits, and suitability varies based on the patient's specific condition.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, there may be pain and discomfort at the surgery site, manageable with medication. Patients may experience limited mobility during recovery and should follow care instructions closely to ensure proper healing.