22630 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar

Name of the Procedure:

Arthrodesis, Posterior Interbody Technique (Laminectomy and/or Discectomy for Interspace Preparation, Single Interspace; Lumbar)

Summary

Arthrodesis, commonly known as spinal fusion, in the lumbar region (lower back) involves joining two or more vertebrae to reduce motion between them. Using the posterior interbody technique, surgeons remove parts of the disc and bone to fuse the vertebrae together, providing stability and alleviating pain.

Purpose

The procedure addresses spinal instability or degenerative disc disease. The goal is to alleviate chronic pain and improve spinal stability to enhance the patient's quality of life and mobility.

Indications

• Chronic lower back pain unresponsive to conservative treatments.
• Lumbar spine instability or deformity.
• Degenerative disc disease or spondylolisthesis.
• Severe disc herniation or spinal stenosis.

Preparation

• Patients may need to fast for several hours before the procedure.
• They must adjust medications as advised by their healthcare provider.
• Preoperative assessments may include blood tests, imaging studies (X-rays, MRI, CT scans), and a physical examination.

Procedure Description

1. General or regional anesthesia is administered to the patient.
2. The patient is positioned prone (face down) on the operating table.
3. The surgeon makes an incision over the lumbar spine and retracts muscles to access the spinal column.
4. A laminectomy and/or discectomy is performed to remove the affected disc and any impinging bone.
5. The interbody space is prepared for fusion, often using bone grafts or synthetic materials.
6. The vertebrae are aligned and fixed together with screws and rods to promote fusion.
7. The incision is closed, and surgical dressings are applied.

Duration

Typically, the procedure lasts between 2 to 5 hours, depending on the complexity.

Setting

The procedure is performed in a hospital or surgical center with appropriate facilities.

Personnel

• Orthopedic spine surgeon or neurosurgeon
• Anesthesiologist
• Operating room nurses and surgical technologists

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Nonunion (failure of the bones to fuse)
• Hardware complications (e.g., breaking or dislodgement of screws/rods)

Benefits

• Reduction or elimination of lower back pain.
• Improved spine stability and function.
• Enhanced quality of life and mobility. Benefits are typically realized within a few months post-surgery.

Recovery

• Postoperative hospital stay of a few days.
• Pain management with medications.
• Physical therapy to aid recovery.
• Restrictions on heavy lifting and certain activities for several weeks to months.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Conservative treatments (physical therapy, medications, injections).
• Other surgical options (e.g., minimally invasive spine surgery).
• Pros and cons vary; alternatives may have fewer risks but might not offer the same level of symptom relief.

Patient Experience

During the procedure, patients are under anesthesia and feel no pain. Post-surgery, they may experience discomfort and restricted mobility, which can be managed with pain medications and supportive care until they fully recover.