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Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments

CPT4 code

Name of the Procedure:

Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments. Also known as spinal fusion.

Summary

This procedure involves the surgical fusion of up to six vertebral segments in the spine to correct spinal deformities. It involves using bone grafts and sometimes hardware to achieve spinal stability and alignment.

Purpose

Arthrodesis aims to correct spinal deformities, provide spinal stability, and alleviate pain. This can help improve posture and function and prevent further spinal deformity.

Indications

  • Severe scoliosis (curvature of the spine)
  • Kyphosis (hunchback)
  • Chronic back pain not responsive to other treatments
  • Spinal instability due to fractures or degenerative diseases
  • Congenital spinal deformities

Preparation

  • Fasting for several hours prior to surgery
  • Adjusting current medications under the direction of a physician
  • Undergoing diagnostic tests like X-rays, MRIs, or CT scans
  • Complete blood work and possibly a pre-operative physical exam

Procedure Description

  1. Anesthesia: The patient is given general anesthesia.
  2. Incision: A surgical incision is made along the posterior (back) part of the spine.
  3. Exposure: Muscles and tissues are carefully moved aside to expose the vertebrae.
  4. Fusion: Bone grafts or synthetic bone materials are placed between the vertebrae. Metal rods, screws, or plates may be used to stabilize the spine.
  5. Final Steps: The incision is closed, and the area is dressed. In some cases, a cast or brace is applied.

Duration

The procedure usually takes between 4 to 6 hours, depending on the complexity.

Setting

This procedure is typically performed in a hospital operating room.

Personnel

  • Orthopedic or neurosurgeon
  • Anesthesiologist
  • Surgical nurses
  • Possibly a surgical technician

Risks and Complications

  • Infection
  • Blood clots
  • Nerve damage
  • Non-union (failure of the bones to fuse)
  • Hardware failure

Benefits

  • Improved spinal alignment
  • Reduced pain
  • Enhanced stability and function
  • Prevention of further deformity

Recovery

  • Hospital stay from a few days to a week
  • Pain management with prescribed medications
  • Limited activity and avoiding heavy lifting for several weeks to months
  • Physical therapy for gradual return to normal activity
  • Follow-up appointments to monitor healing and progress

Alternatives

  • Non-surgical treatments like physical therapy and bracing
  • Pain management strategies
  • Other surgical techniques like minimally invasive spinal surgery Pros and cons of alternatives depend on the specific condition and patient needs.

Patient Experience

  • During: The patient will be under general anesthesia and won’t feel any pain.
  • After: Postoperative pain and discomfort are common, managed with medications. Some temporary restrictions in movement and activity are expected. Pain and stiffness usually improve over weeks to months.
  • Long-term: Gradual improvement in function and reduction in pain. Full recovery may take several months.

Medical Policies and Guidelines for Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments

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