Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus
CPT4 code
Name of the Procedure:
Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus.
Summary
Neuroplasty of the lumbar plexus is a surgical procedure aimed at relieving pressure and repairing damage to the major peripheral nerves in the lower spine region. It involves an open surgical approach to directly access and treat the affected nerves.
Purpose
This surgery is typically used to address conditions where there is compression, damage, or entrapment of the nerves within the lumbar plexus. The goals are to alleviate pain, restore nerve function, and improve mobility and quality of life.
Indications
- Chronic pain, numbness, or weakness in the leg or lower back due to nerve compression.
- Conditions such as lumbar radiculopathy, nerve entrapment syndromes, or severe sciatica.
- Patients who have not responded to conservative treatments like physical therapy, medications, or injections.
Preparation
- Patients may need to fast for 8-12 hours before surgery.
- Adjustments to current medications might be necessary; patients should follow their doctor's advice.
- Pre-operatively, diagnostic imaging tests such as MRI or CT scans are usually needed to pinpoint the exact location of nerve compression.
Procedure Description
- The patient is positioned, and anesthesia is administered, typically general anesthesia.
- An incision is made over the lumbar region to expose the affected area of the lumbar plexus.
- The surgeon carefully identifies and isolates the compressed or damaged nerve.
- The nerve is decompressed by removing any surrounding tissue or structures causing pressure.
- If necessary, nerve repair techniques are applied.
- The incision is closed with sutures, and the area is bandaged.
Duration
The procedure typically takes 2-3 hours, depending on the complexity of the case.
Setting
Neuroplasty of the lumbar plexus is performed in a hospital operating room or a surgical center.
Personnel
- Surgeon specialized in neurosurgery or orthopedic surgery.
- Anesthesiologist to administer anesthesia.
- Nurses and surgical technicians to assist during the operation.
Risks and Complications
- Infection at the surgical site.
- Bleeding or hematoma formation.
- Nerve damage leading to worsened symptoms or new neurological deficits.
- Scar tissue formation that might necessitate further treatment.
- Anesthesia-related risks.
Benefits
- Relief from chronic pain and nerve-related symptoms.
- Improved mobility and function in the affected leg.
- Enhanced quality of life and daily functioning, with benefits often noticed within a few weeks post-surgery.
Recovery
- Post-surgery, patients might need to stay in the hospital for a day or two.
- Pain management usually involves medications initially, with a gradual tapering off.
- Physical therapy is often recommended to aid in recovery and restore strength and mobility.
- Full recovery might take several weeks to months, with specific activity restrictions and follow-up appointments to monitor progress.
Alternatives
- Non-surgical treatments like physical therapy, epidural steroid injections, or pain management strategies.
- Minimally invasive procedures such as endoscopic decompression.
- Each alternative has its pros and cons; non-surgical options might have fewer risks but could also be less effective for severe cases.
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel pain. Post-operatively, some discomfort and pain are expected, which can be managed with medication. Most patients experience gradual improvement in symptoms and are encouraged to follow a tailored rehabilitation plan to optimize recovery.