22842 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure)

Name of the Procedure:

Posterior Segmental Instrumentation (e.g., Pedicle Fixation, Dual Rods with Multiple Hooks and Sublaminar Wires); 3 to 6 Vertebral Segments

Summary

Posterior segmental instrumentation is a surgical procedure used to stabilize and correct abnormalities in the spine by placing hardware such as rods, hooks, and wires along 3 to 6 vertebral segments. This hardware helps to support and align the spine.

Purpose

This procedure is used to address spinal deformities, instability, or injuries. The goals are to provide spinal stability, correct deformities, reduce pain, and improve a patient’s quality of life.

Indications

• Scoliosis or kyphosis
• Spinal fractures
• Spinal instability due to degeneration or disease
• Conditions causing severe back pain unresponsive to conservative treatments
• Neurological impairments caused by spinal abnormalities

Preparation

• Fasting for 8 hours prior to the procedure
• Adjusting or stopping certain medications as directed by the surgeon
• Undergoing a series of diagnostic tests such as X-rays, MRI, or CT scans
• Pre-operative physical examination and health assessment

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made along the back over the affected vertebrae.
3. The surgeon accesses the spine and places pedicle screws into the vertebrae.
4. Dual rods are connected to the screws to provide structural support.
5. Hooks and sublaminar wires are used to further stabilize and align the spine.
6. The incision is closed with sutures or staples.
7. A dressing is applied to the surgical site.

Duration

The procedure typically takes between 3 to 6 hours, depending on the complexity.

Setting

Performed in a hospital operating room.

Personnel

• Orthopedic surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Radiologic technologists, if intraoperative imaging is used

Risks and Complications

• Infection
• Blood loss
• Nerve damage
• Hardware failure or displacement
• Persistent pain
• Anesthesia-related complications
• Blood clots

Benefits

• Improved spinal alignment and function
• Reduced pain and discomfort
• Enhanced mobility and quality of life
• Stability to prevent further spinal damage

Recovery

• Hospital stay for 3 to 5 days post-surgery
• Pain management with medications
• Physical therapy may begin a few weeks post-surgery
• Avoid heavy lifting and strenuous activities for several months
• Follow-up appointments for monitoring and X-rays

Alternatives

• Non-surgical treatments such as physical therapy, bracing, or medications
• Minimally invasive surgical options
• Spinal fusion without instrumentation
• The choice of alternative depends on the specific condition and patient health.

Patient Experience

The patient will be under general anesthesia during the procedure and will not feel any pain. Post-surgery, there may be discomfort and pain that will be managed with medications. The patient might experience limited mobility and will need assistance during the initial recovery period. Pain and mobility typically improve over time with proper post-operative care and physical therapy.