Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)
CPT4 code
Name of the Procedure:
Arthrodesis, posterior or posterolateral technique, single level; lumbar (with lateral transverse technique, when performed)
Summary
Arthrodesis, commonly known as spinal fusion, is a surgical procedure where two or more vertebrae in the spine are permanently joined to eliminate motion between them. This specific procedure targets the lumbar (lower back) region and employs a posterior or posterolateral approach, with the addition of a lateral transverse technique if necessary.
Purpose
This procedure is primarily performed to address chronic lower back pain, spinal instability, or deformities when other treatments have failed. The goals are to reduce pain, stabilize the spinal segment, and possibly correct deformities, thereby improving overall spinal function.
Indications
- Chronic lower back pain not responsive to conservative treatments
- Spinal instability or degenerative disc disease
- Spinal deformities such as scoliosis or spondylolisthesis
- Spinal fractures or tumors requiring stabilization
Preparation
- Fasting for at least 8 hours prior to the procedure
- Adjustments or cessation of certain medications (e.g., blood thinners)
- Pre-operative imaging tests such as X-rays, MRI, or CT scans
- Completion of a pre-surgical health assessment and consultation with the surgical team
Procedure Description
- Anesthesia: The patient is put under general anesthesia.
- Incision: An incision is made in the lower back along the midline.
- Spinal Access: Muscles and tissues are retracted to expose the spine.
- Preparation: Damaged discs or bone parts are removed.
- Fusion: Bone graft material is placed between the affected vertebrae.
- Stabilization: Metal rods, screws, or plates may be installed to stabilize the spine.
- Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
Tools and Technology: Surgical instruments, bone graft materials, metal hardware (screws, rods, plates)
Duration
The procedure typically takes between 3 to 6 hours.
Setting
Arthrodesis is performed in a hospital operating room or a specialized surgical center.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Radiology technician (if imaging is needed during surgery)
Risks and Complications
- Infection
- Blood clots
- Nerve damage
- Hardware malfunction
- Nonunion (failure of the bones to fuse)
- Post-surgical pain
Benefits
- Reduction of chronic lower back pain
- Improved spinal stability and alignment
- Enhanced ability to perform daily activities
- Long-term relief of symptoms
Recovery
- Hospital stay of a few days for monitoring
- Pain management with medications
- Physical therapy to regain strength and mobility
- Limited activity for several months
- Follow-up appointments to monitor fusion progress
Alternatives
- Non-surgical treatments: physical therapy, medications, spinal injections
- Minimally invasive spinal surgery
- Artificial disc replacement
Pros of Alternatives: Less invasive, shorter recovery time Cons of Alternatives: May not be effective for severe cases, possible need for future surgeries
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel pain. Post-procedure, there may be significant discomfort and stiffness, managed with pain medications. Recovery involves restricted movement and gradual return to normal activities under medical supervision.