22844 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more 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); 13 or More Vertebral Segments

Summary

In Posterior Segmental Instrumentation, the surgeon stabilizes the spine by attaching rods and screws to multiple vertebrae. This procedure often includes the use of hooks and wires to provide additional support. It is typically used for treating spinal deformities such as scoliosis or for stabilizing the spine following a fracture.

Purpose

This procedure is designed to correct spinal deformities or provide stability to the spine after injury. The primary goal is to realign and support the spine, reduce pain, and prevent further spinal deterioration.

Indications

• Severe scoliosis or kyphosis
• Spinal fractures
• Spinal instability
• Degenerative spine conditions requiring stabilization
• Previous failed spinal surgeries that require additional correction

Preparation

• The patient may be instructed to fast for 8-12 hours before surgery.
• Certain medications, particularly blood thinners, may need to be adjusted or stopped before surgery.
• Pre-operative imaging studies (e.g., MRI, CT scans, X-rays) to plan the surgery.
• Blood tests and a pre-surgical physical exam to assess overall health.

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes an incision along the back to access the spine.
3. Muscle tissue is carefully moved aside to expose the vertebrae.
4. Pedicle screws are inserted into specific vertebrae.
5. Rods are attached to the screws to align and stabilize the spine.
6. Additional hooks and sublaminar wires may be used for extra stabilization.
7. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 4-6 hours, depending on the complexity and number of segments involved.

Setting

Posterior Segmental Instrumentation is performed in a hospital operating room.

Personnel

• Orthopedic surgeon or neurosurgeon specializing in spine surgery
• Anesthesiologist
• Surgical nurses
• Operative technologists

Risks and Complications

• Infection
• Bleeding
• Nerve damage resulting in numbness, weakness, or paralysis
• Hardware failure or displacement
• Blood clots
• Anesthetic complications

Benefits

• Improved spinal alignment and stability
• Reduced pain
• Prevention of further spinal deformity
• Enhanced quality of life and mobility

Recovery

• Hospital stay of 3-7 days post-surgery.
• Pain management with medications.
• Restricted activities for several weeks; avoid heavy lifting and bending.
• Physical therapy may be recommended to strengthen the spine and improve mobility.
• Follow-up appointments to monitor healing and hardware integrity.

Alternatives

• Conservative treatments such as physical therapy, bracing, and medications.
• Less invasive surgical options if applicable.
• Pros: Non-surgical alternatives avoid surgical risks and complications.
• Cons: May not be effective for severe deformities or instability.

Patient Experience

• During the procedure: Patient will be under general anesthesia and will not experience any sensation.
• After the procedure: Pain and discomfort managed with medications. Gradual improvement in symptoms as healing progresses. Adherence to post-operative care instructions is crucial for optimal recovery.