Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspa
CPT4 code
Name of the Procedure:
Arthrodesis, Combined Posterior or Posterolateral Technique with Posterior Interbody Technique Including Laminectomy and/or Discectomy Sufficient to Prepare Interspace (Other Than for Decompression), Single Interspace and Segment; Each Additional Interspace
Summary
This procedure involves fusing two or more vertebrae in the spine using a combination of posterior or posterolateral techniques along with posterior interbody techniques. The surgery includes removing part of the vertebra or disc material to prepare the interspace for fusion.
Purpose
Arthrodesis is performed to stabilize the spine, reduce pain, and correct deformities or spinal instability caused by conditions like degenerative disc disease, spondylolisthesis, or severe scoliosis. The expected outcome is a stable and pain-free spine segment.
Indications
- Severe back pain not relieved by conservative treatments
- Spinal instability or deformity
- Degenerative disc disease
- Spondylolisthesis
- Failed previous spinal surgery
Preparation
- Fasting for 6 to 8 hours before the procedure
- Stopping certain medications (e.g., blood thinners) as advised by the healthcare provider
- Preoperative imaging tests like X-rays, MRI, or CT scans
- Blood tests to assess general health
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A surgical incision is made in the back to access the spine.
- Laminectomy/Discectomy: Removal of part of the vertebral arch (lamina) or the disc material to prepare the interspace.
- Implant Placement: Bone grafts and/or metal implants are placed between the vertebrae to facilitate fusion.
- Fusion: The prepared interspace is packed with bone graft material to promote fusion.
- Closure: The incision is closed with sutures or staples.
Duration
The procedure typically takes 4 to 8 hours, depending on the number of vertebrae being fused.
Setting
Performed in a hospital operating room.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Radiologic technologist (if intraoperative imaging is used)
Risks and Complications
- Infection
- Blood clots
- Nerve damage
- Failure of the bones to fuse (nonunion)
- Persistent pain
- Reaction to anesthesia
Benefits
- Stabilization of the spine
- Reduction or elimination of back pain
- Improvement in mobility and function
- Correction of spinal deformity
Recovery
- Hospital stay of 2 to 4 days
- Pain management with medications
- Physical therapy and rehabilitation
- Wearing a back brace for support
- Avoiding heavy lifting and strenuous activities
- Full recovery may take several months
Alternatives
- Conservative treatments (physical therapy, medications, epidural injections)
- Minimally invasive spine surgery
- Spinal decompression without fusion
Patient Experience
- Patients may experience initial pain and discomfort post-surgery, which is managed with pain medications.
- Gradual improvement in pain and functionality over weeks to months.
- Physical discomfort due to wearing a brace and limited mobility during the initial recovery phase.