Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar
CPT4 code
Name of the Procedure:
Osteotomy of Spine, Posterior or Posterolateral Approach, 1 Vertebral Segment; Lumbar
Summary
An osteotomy of the spine using a posterior or posterolateral approach involves surgically cutting and reshaping one vertebral segment in the lumbar (lower back) region to correct deformities or relieve pressure on the spinal cord or nerves.
Purpose
This procedure addresses conditions like spinal deformities (e.g., scoliosis, kyphosis), spinal stenosis, or fractures that require stable realignment. The goal is to reduce pain, improve spinal alignment, and restore function.
Indications
- Severe or progressive spinal deformity
- Lumbar spinal stenosis causing significant symptoms
- Lumbar vertebral fractures not amenable to less invasive treatments
- Persistent pain or disability due to spinal structural issues
Preparation
- Fasting for at least 8 hours before the surgery
- Stopping certain medications, such as blood thinners, as advised
- Preoperative imaging tests (e.g., X-rays, MRIs) to plan the surgery
Procedure Description
- Patient is given general anesthesia.
- The patient is positioned prone on the operating table.
- A posterior or posterolateral incision is made over the affected lumbar vertebra.
- Muscles and tissues are carefully retracted to expose the vertebrae.
- The surgeon uses specialized tools to cut and reshape the vertebral segment.
- Stabilization may involve screws, rods, or bone grafts.
- The incision is closed in layers with sutures or staples.
Duration
The procedure typically takes between 2 to 4 hours.
Setting
The procedure is performed in a hospital, often in an operating room equipped for spinal surgery.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Scrub technician
- Radiologic technician (if intraoperative imaging is used)
Risks and Complications
- Infection
- Blood loss
- Dural tears leading to cerebrospinal fluid leaks
- Nerve damage causing weakness or numbness
- Nonunion or poor healing of the bone
- Instrumentation failure
Benefits
- Reduction or elimination of back pain
- Improved spinal alignment and posture
- Enhanced mobility and function
- Long-term relief from nerve compression symptoms
Recovery
- Initial hospital stay of 3 to 5 days
- Pain management with medications
- Physical therapy starting a few weeks post-surgery
- Limit activities such as heavy lifting for several months
- Follow-up appointments for monitoring healing and functionality
Alternatives
- Physical therapy and pain management
- Minimally invasive spinal surgery
- Spinal fusion without osteotomy
- Orthotic bracing
Patient Experience
Patients may feel groggy and sore immediately after surgery. Pain is managed with medications, and some discomfort is normal. Physical therapy helps regain strength and mobility. Adherence to postoperative instructions and follow-ups is crucial for optimal recovery.