Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar
CPT4 code
Name of the Procedure:
Arthrodesis, Lateral Extracavitary Technique, including Minimal Discectomy to Prepare Interspace (Other than for Decompression); Lumbar
Summary
Arthrodesis, commonly known as spinal fusion, is a surgical procedure to fuse two or more vertebrae in the lumbar spine (lower back). The lateral extracavitary technique accesses the spine from the side of the body, and minimal discectomy involves removing a small portion of the intervertebral disc to prepare the site for fusion.
Purpose
Spinal fusion is performed to treat severe back pain, spinal instability, or deformities. The goal is to stabilize the spine, alleviate pain, and improve overall functionality.
Indications
- Chronic lower back pain unresponsive to conservative treatments
- Spinal instability or spondylolisthesis (slipped vertebra)
- Degenerative disc disease
- Spinal deformities such as scoliosis
- Conditions leading to nerve compression and radiculopathy
Preparation
- Fasting for 8-12 hours before the procedure
- Adjustments or cessation of certain medications as directed by the healthcare provider
- Pre-operative diagnostic tests such as X-rays, MRI, or CT scans
- Discussion about the procedure, risks, and obtaining informed consent
Procedure Description
- The patient is administered general anesthesia.
- The patient is positioned on their side.
- An incision is made on the side of the body to access the lumbar spine.
- Minimal discectomy is performed by removing part of the intervertebral disc to prepare the fusion site.
- Bone graft material is placed between the vertebrae to promote bone growth and fusion.
- Screws, rods, or other hardware may be used to stabilize the spine.
- The incision is closed with sutures or staples.
Tools and technologies utilized include surgical instruments for discectomy and fusion, imaging guidance systems, bone graft materials, and stabilization hardware.
Duration
The procedure typically takes 3-6 hours, depending on the extent of the fusion.
Setting
The procedure is performed in a hospital operating room under sterile conditions.
Personnel
- Orthopedic or neurosurgeon specialized in spine surgery
- Surgical nurses and technologists
- Anesthesiologist
- Radiologist (for imaging guidance)
Risks and Complications
- Infection
- Bleeding and blood clots
- Nerve damage
- Nonunion (failure of the vertebrae to fuse)
- Hardware-related issues
- Chronic pain
Benefits
- Reduction or elimination of chronic back pain
- Improved spinal stability and posture
- Enhanced quality of life and daily functioning
- Immediate stabilization with hardware; bone fusion may take several months
Recovery
- Hospital stay of 2-5 days post-surgery
- Pain management with medications
- Instructions on wound care and activity restrictions
- Physical therapy to regain strength and mobility
- Follow-up appointments to monitor healing and fusion progress
- Full recovery may take 6 months to a year
Alternatives
- Conservative treatments like physical therapy, medications, and spinal injections
- Other surgical techniques like posterior lumbar fusion or anterior lumbar interbody fusion
- Pros of alternatives include less invasive procedures, quicker recovery; cons might include less stability or lower success rates for severe cases
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel pain. Post-procedure, patients may experience pain and discomfort, managed with medications. They may feel soreness at the incision site and stiffness in the back. Adhering to post-operative care instructions and attending physical therapy sessions will aid in a smooth recovery and pain reduction.