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Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar
CPT4 code
Name of the Procedure:
Open Treatment and/or Reduction of Vertebral Fracture(s) and/or Dislocation(s), Posterior Approach, 1 Fractured Vertebra or Dislocated Segment; Lumbar
Summary
This surgical procedure involves the repair or realignment of a fractured or dislocated lumbar vertebra using a posterior (back) approach. The surgery aims to stabilize the spine, alleviate pain, and prevent further neurological damage.
Purpose
Medical Condition: This procedure addresses fractures or dislocations in the lumbar spine. Goals:
- Stabilize the spine
- Relieve pain
- Restore normal alignment
- Prevent further neurological injury
Indications
Symptoms or Conditions:
- Severe back pain
- Neurological deficits (e.g., numbness, weakness)
- Spinal instability Criteria:
- Traumatic injury to the lumbar spine
- Failure of non-surgical treatments
- Evidence of spinal cord or nerve compression
Preparation
Instructions:
- Fasting for 8 hours prior to surgery
- Medication adjustments as per physician's guidance Pre-assessments:
- MRI or CT scans
- Blood tests
- Cardiac evaluation if necessary
Procedure Description
- Patient is placed under general anesthesia.
- An incision is made in the lower back.
- Muscles and tissues are carefully moved to access the affected vertebra.
- Fractured or dislocated vertebra is realigned or repaired.
- Metal screws, rods, or plates may be used to stabilize the spine.
- Incision is closed with sutures or staples.
- Surgical site is covered with a sterile dressing.
Tools and Equipment:
- Surgical instruments (scalpels, clamps)
- Imaging devices (fluoroscopy)
- Stabilization hardware (screws, rods)
Duration
Typically takes 3 to 5 hours, depending on the complexity.
Setting
Performed in a hospital operating room under sterile conditions.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
- Radiologic technologist (for intraoperative imaging)
Risks and Complications
Common Risks:
- Infection
- Blood loss
- Pain at the incision site Rare Risks:
- Nerve damage
- Blood clots
- Adverse reactions to anesthesia
- Hardware failure or malposition
Benefits
Expected Benefits:
- Pain relief
- Restored spinal alignment
- Stabilized spine Realization Time: Most patients experience significant pain reduction and improved mobility within a few weeks to a few months.
Recovery
Post-procedure Care:
- Pain management with medications
- Physical therapy
- Avoid heavy lifting and twisting movements Expected Recovery Time: 6 to 12 weeks Follow-up: Regular check-ups with the surgeon for progress assessment.
Alternatives
Other Options:
- Conservative treatments (bracing, physical therapy)
- Minimally invasive procedures Pros and Cons:
- Conservative treatments are less invasive but may be less effective for severe cases.
- Minimally invasive procedures have shorter recovery times but may not be suitable for complex fractures or dislocations.
Patient Experience
During Procedure:
- Patient will be asleep under general anesthesia. After Procedure:
- Initial pain managed with medications
- Discomfort and soreness at the incision site Pain Management: Pain medications, physical therapy for mobility and strength building. Comfort measures include proper positioning and use of supportive devices like braces or walkers.