22818 Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments

Name of the Procedure:

Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s); single or 2 segments.

Summary

A kyphectomy is a surgical procedure that involves exposing and removing one or two segments of a vertebra (including both the body's front and back parts). This surgery is used to correct severe spinal deformities and alleviate associated problems.

Purpose

The medical condition it addresses is typically severe kyphosis (abnormal forward curvature of the spine) or other spinal deformities that affect the patient's posture and overall health. The goal of the procedure is to correct the spinal alignment, relieve pain, and prevent further complications such as nerve compression.

Indications

• Severe kyphosis or spinal deformities.
• Chronic back pain not relieved by conservative treatments.
• Neurological symptoms due to spinal compression.
• Progressive deformity affecting lung or heart function.

Preparation

• Fasting for at least 8 hours before surgery.
• Adjusting or stopping certain medications as advised by the physician.
• Preoperative imaging studies like X-rays, MRI or CT scans.
• Blood tests and a complete medical evaluation.

Procedure Description

1. The patient is positioned under general anesthesia.
2. A circumferential exposure of the spine is made (both front and back parts).
3. The surgeon removes the affected vertebral segment(s), including both the vertebral body and the posterior elements.
4. Spinal realignment and stabilization are achieved using rods, screws, or bone grafts.
5. The incision is closed, and dressings are applied.

Duration

The procedure typically takes between 4 to 8 hours, depending on the complexity.

Setting

This surgery is performed in a hospital equipped with surgical facilities, often in a specialized surgical center.

Personnel

• Orthopedic or neurosurgeons specializing in spinal surgery.
• Anesthesiologists.
• Surgical nurses.
• Operating room technicians.

Risks and Complications

• Infection.
• Blood loss.
• Neurological complications (e.g., nerve damage).
• Nonunion or poor healing of the spine.
• Anesthesia-related risks.

Benefits

• Improved spinal alignment and posture.
• Relief from chronic pain.
• Prevention of further spinal deterioration.
• Potential improvement in respiratory and cardiovascular function if affected by spinal deformity. Outcomes can vary, and the full benefits may be realized over several months.

Recovery

• Hospital stay for observation and initial recovery (usually 5 to 7 days).
• Pain management with medications.
• Gradual return to activities over weeks to months.
• Physical therapy to aid in mobility and strengthening.
• Follow-up appointments for monitoring progress and spinal fusion healing.

Alternatives

• Non-surgical treatments like physical therapy, bracing, or medications.
• Less invasive surgical options depending on severity and location of the deformity.
• Each alternative has its benefits and drawbacks which should be discussed with a healthcare provider.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. After the surgery, patients may experience pain and discomfort, which will be managed with medications. Postoperative care includes managing drains, dressings, and gradually increasing mobility. Full recovery and return to normal activities can take several months, and patients will need to adhere to follow-up and physical therapy for optimal recovery.