22224 Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar

Name of the Procedure:

Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar

Summary

An osteotomy of the spine with discectomy and anterior approach involves surgically removing a damaged disc in the lumbar (lower back) region and realigning the spine by cutting a bone. This procedure aims to relieve pain and correct spinal deformities.

Purpose

The procedure addresses spinal problems such as disc degeneration, deformities, and instability in the lumbar region. The goals are to alleviate pain, restore spinal stability, and improve the patient's mobility and quality of life.

Indications

The procedure is indicated for:

• Severe lumbar disc degeneration
• Chronic lower back pain not relieved by conservative treatments
• Spinal deformities, such as scoliosis or kyphosis
• Spinal instability Patients should be in generally good health and not have conditions that significantly increase surgical risks.

Preparation

• Patients may need to fast for 8-12 hours before surgery.
• Adjustments to medications, such as blood thinners, may be required.
• Preoperative tests: MRI, CT scan, X-rays, blood tests, and a physical examination.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A surgeon makes an incision in the abdomen to access the spine.
3. Discectomy: Removal of the damaged disc.
4. Osteotomy: Bone is cut to realign and stabilize the spine.
5. Stabilization: Metal plates, screws, or rods may be used to stabilize the spine.
6. Closure: The incision is closed with sutures or staples.

Tools: Surgical instruments, imaging for guidance, stabilization devices.

Duration

The procedure typically takes 3-6 hours, depending on complexity.

Setting

Performed in a hospital operating room.

Personnel

• Orthopedic or spinal surgeon
• Surgical assistants
• Anesthesiologist
• Operating room nurses
• Radiologic technologists (if intraoperative imaging is used)

Risks and Complications

• Common: Infection, bleeding, blood clots, nerve damage.
• Rare: Paralysis, reaction to anesthesia, hardware failure. Management includes antibiotics, blood transfusions, or further surgeries if needed.

Benefits

• Pain relief
• Improved spinal stability and alignment
• Enhanced mobility and quality of life Benefits typically realized within a few weeks to months post-surgery.

Recovery

• Hospital stay: 3-5 days post-surgery.
• Limited activity and movement initially.
• Physical therapy: To regain strength and mobility.
• Pain management: Medications as prescribed.
• Follow-up appointments: Regular visits for monitoring recovery. Full recovery may take several months.

Alternatives

• Non-surgical treatments: Physical therapy, medications, steroid injections.
• Less invasive surgeries: Microdiscectomy, spinal fusion. Pros and Cons: Less invasive options have quicker recoveries but may not offer the same long-term benefits for severe conditions.

Patient Experience

During the procedure: The patient is under general anesthesia and will not feel anything. After the procedure: Pain and discomfort are common; managed with medications. Some activity restrictions will be necessary. Physical therapy aids recovery, and gradual improvement is expected over several months.