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Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical

CPT4 code

Name of the Procedure:

Partial Excision of Vertebral Body for Intrinsic Bony Lesion, Cervical (Without Decompression of Spinal Cord or Nerve Roots)

Summary

This surgical procedure involves removing part of a vertebral body in the cervical spine (neck area) due to an abnormal bony lesion. It is performed without decompressing the spinal cord or nerve roots.

Purpose

The procedure is intended to treat intrinsic bony lesions within a cervical vertebra, which could be benign or malignant. The primary goal is to alleviate pain or prevent further complications without compromising spinal stability or nerve function.

Indications

  • Presence of an intrinsic bony lesion (e.g., tumor, cyst, or bone disease) in the cervical vertebra.
  • Persistent pain or discomfort not relieved by non-surgical treatments.
  • Risk of lesion growth leading to structural instability.
  • Lack of involvement of spinal cord or nerve roots, negating the need for decompression.

Preparation

  • Patients may need to fast for 8-12 hours before the procedure.
  • Medication adjustments may be required, especially blood thinners.
  • Preoperative imaging (MRI, CT scans) and blood tests to assess the lesion and general health.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. An incision is made in the neck to access the cervical spine.
  3. Using specialized surgical tools, the surgeon carefully removes part of the vertebral body that contains the bony lesion.
  4. The area is inspected to ensure all abnormal tissue is excised.
  5. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2-4 hours, depending on the complexity and location of the lesion.

Setting

Usually performed in a hospital operating room or a specialized surgical center.

Personnel

  • Orthopedic or Neurosurgeon
  • Surgical Nurse
  • Anesthesiologist
  • Operating Room Technician

Risks and Complications

  • Infection
  • Bleeding
  • Damage to surrounding tissues or nerves
  • Spinal instability
  • Adverse reactions to anesthesia

Benefits

  • Reduction or elimination of pain caused by the lesion.
  • Prevention of further growth and complications related to the lesion.
  • Improved quality of life with minimal impact on spinal function.

Recovery

  • Initial post-procedure hospitalization for 1-3 days for monitoring.
  • Pain management with medications.
  • Limited neck movement and gradual rehabilitation exercises.
  • Follow-up appointments for wound checks and imaging to ensure healing.

Alternatives

  • Non-surgical treatments like radiation therapy or medications.
  • Complete vertebral body excision with potential decompression.
  • Monitoring with regular imaging and pain management without immediate surgery.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel pain. Post-procedure, they may experience discomfort and pain, which is managed with medications. Recovery involves rest and limited activity, with gradual resumption of normal activities as healing progresses.

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