Electrical stimulation to aid bone healing; invasive (operative)
CPT4 code
Name of the Procedure:
Electrical Stimulation to Aid Bone Healing; Invasive (Operative)
Common name(s): Internal Bone Growth Stimulation, Electrical Osteogenesis Stimulation
Technical terms: Invasive Electrical Stimulation for Osteogenesis
Summary
Invasive electrical stimulation to aid bone healing is a surgical procedure that involves implanting a device near the bone fracture site. This device delivers controlled electrical currents to promote bone growth and healing, especially in cases where natural healing is slow or impaired.
Purpose
- Medical Condition: Treats delayed union or nonunion of bone fractures.
- Goals: Enhance and accelerate bone healing, reduce the risk of a permanent non-union, and improve functional recovery of the affected limb.
Indications
- Non-healing bone fractures (nonunion)
- Delayed healing of bones (delayed union)
- Inadequate response to conservative treatments such as casts or braces
- Patients with medical conditions or risk factors inhibiting bone healing (e.g., diabetes, smoking, osteoporosis)
Preparation
- Preoperative imaging: X-rays, CT scans, or MRI to locate the fracture and plan the procedure.
- Fasting for 8-12 hours before surgery.
- Adjustment of medications: Temporary discontinuation of blood thinners or other medications as directed by the surgeon.
- Preoperative consultation: Discussing the procedure, risks, benefits, and obtaining informed consent.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
- Incision: A small surgical incision is made near the site of the bone fracture.
- Implantation: The electrical stimulation device is implanted near the bone. Electrodes are positioned to deliver electrical currents directly to the fracture site.
- Setup: The device settings are programmed to deliver the appropriate frequency and intensity of electrical currents.
- Closure: The incision is closed with sutures or surgical staples.
- Monitoring: The patient's vital signs and the functioning of the device are monitored.
Duration
The procedure typically takes 1 to 2 hours.
Setting
The procedure is performed in a hospital surgical suite or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Surgical nurse
- Anesthesiologist
- Operating room technicians
Risks and Complications
- Infection at the incision site.
- Device malfunction or failure.
- Pain or discomfort at the implantation site.
- Rare reactions to anesthesia.
- Potential need for additional surgeries or procedures.
Benefits
- Accelerated bone healing.
- Increased likelihood of complete fracture healing.
- Reduced immobilization period and quicker return to normal activities.
- Enhanced overall functional recovery of the affected bone or limb.
Recovery
- Postoperative care: Wound care, pain management with medications, and monitoring for any signs of infection.
- Activity restrictions: Limiting weight-bearing or movement based on the fracture site.
- Follow-up: Regular follow-up appointments for X-rays and assessment of healing progress.
- Expected recovery time: Several weeks to months, depending on the severity of the fracture and individual healing rates.
Alternatives
- Non-invasive bone growth stimulation
- Casts or braces (conservative management)
- Bone grafting or surgical fixation with plates and screws
- Pros and cons: Non-invasive options avoid surgical risks but may be less effective in severe cases; more invasive surgery may offer faster results but comes with increased risks.
Patient Experience
- During: The procedure is performed under general anesthesia, so the patient will not feel anything during surgery.
- Postoperative: Some pain and discomfort at the incision site can be managed with medications.
- Recovery period: Gradual mobilization, adherence to activity restrictions, and physical therapy may be required for optimal recovery.
- Pain management: Pain relief through medications and other comfort measures as needed during the recovery process.