Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each inter
CPT4 code
Name of the Procedure:
Insertion of Interbody Biomechanical Device(s) (e.g., Synthetic Cage, Mesh) with Integral Anterior Instrumentation for Device Anchoring (e.g., Screws, Flanges) to Intervertebral Disc Space in Conjunction with Interbody Arthrodesis
Summary
This procedure involves placing a synthetic device, such as a cage or mesh, into the space between the vertebrae to support and stabilize the spine. It is done as part of spinal fusion surgery, where the goal is to fuse two or more vertebrae together using the device and securing it with screws or flanges.
Purpose
The procedure addresses conditions that involve spinal instability or degenerative disc disease. The goal is to stabilize the spine, relieve pain, and reduce neurological deficits by encouraging bone growth between the vertebrae.
Indications
- Chronic back pain due to degenerative disc disease
- Spinal instability or deformities
- Herniated disc causing significant pain or neurological symptoms
- Failed previous spinal surgeries
- Specific conditions such as spinal stenosis or spondylolisthesis
Preparation
- Fasting for a specified period before surgery
- Adjustment of medications, especially anticoagulants or antiplatelet drugs
- Pre-operative diagnostic imaging (e.g., MRI, CT scans)
- Blood tests and other routine pre-surgical assessments
Procedure Description
- The patient is positioned and administered general anesthesia.
- An incision is made to access the spine.
- The intervertebral disc is removed.
- The synthetic cage or mesh is inserted into the disc space.
- Screws or flanges are used to anchor the device securely.
- Bone graft material is placed around the device to promote fusion.
- The incision is closed and the patient is taken to recovery.
Duration
Typically, the procedure lasts between 2 to 4 hours, depending on the complexity.
Setting
This procedure is usually performed in a hospital operating room or a specialized surgical center.
Personnel
- Spine surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technologists
Risks and Complications
- Infection
- Blood loss
- Nerve injury
- Device migration or failure
- Incomplete fusion (nonunion)
- Pain at the graft site
- Blood clots
Benefits
- Reduced back pain
- Improved stability and alignment of the spine
- Enhanced quality of life
- Reduced need for additional spinal surgeries
Recovery
- Hospital stay of 1 to 3 days
- Pain management with medications
- Limited physical activity for several weeks
- Physical therapy for rehabilitation
- Follow-up appointments for monitoring fusion progress
Alternatives
- Conservative treatments (e.g., physical therapy, medications)
- Other surgical options like laminectomy or discectomy without fusion
- Minimally invasive spinal procedures
Patient Experience
The patient will be under general anesthesia during the surgery and won't feel anything. Post-surgery, there may be pain and discomfort, which can be managed with medications. Gradual improvement in symptoms is expected, with full recovery taking several months. Physical therapy plays a crucial role in regaining strength and mobility.