Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments
CPT4 code
Name of the Procedure:
Arthrodesis, Posterior, for Spinal Deformity (7 to 12 Vertebral Segments)
Summary
Arthrodesis, also known as spinal fusion, is a surgical procedure aimed at correcting spinal deformities by permanently joining together 7 to 12 vertebral segments in the spine through the posterior (back) approach. This may be done with or without the use of a cast post-surgery.
Purpose
This procedure addresses spinal deformities such as scoliosis, kyphosis, or other conditions causing abnormal curvature of the spine. The goal is to stabilize and correct the spine, alleviate pain, and improve overall function and posture.
Indications
- Severe scoliosis or kyphosis
- Degenerative spinal conditions
- Spinal instability due to fractures or tumors
- Congenital spinal deformities
- Patients with significant pain and functional impairment not responsive to non-surgical treatments
Preparation
- Fasting for at least 8 hours before surgery
- Adjusting or stopping certain medications as advised by the doctor
- Pre-operative imaging, such as X-rays, MRI, or CT scans
- Blood tests and general health assessments
- Discussing anesthesia options with the anesthesiologist
Procedure Description
- Anesthesia: The patient is given general anesthesia to ensure they are asleep and pain-free during the procedure.
- Incision: A surgical incision is made along the back to expose the spine.
- Preparation of Vertebrae: The surgeon prepares the affected vertebrae by removing the cartilage between them.
- Bone Grafting: Bone grafts are placed between the vertebrae. These grafts can be taken from the patient's body (autograft), a donor (allograft), or synthetic materials.
- Instrumentation: Metal rods, screws, and plates may be used to keep the spine stable and correctly aligned.
- Closure: The incision is closed with sutures or staples, and a dressing is applied.
Duration
The procedure typically takes between 4 to 8 hours, depending on the complexity and number of segments involved.
Setting
Performed in a hospital operating room equipped with specialized spinal surgery tools and technology.
Personnel
- Orthopedic or Neurosurgeon
- Surgical assistants
- Anesthesiologist
- Scrub nurses
- Circulating nurses
Risks and Complications
- Infection
- Blood loss requiring transfusion
- Nerve damage leading to numbness or weakness
- Failure of bone graft to solidify
- Hardware complications (e.g., breakage or migration)
- Persistent pain or deformity
- Blood clots
- Respiratory or cardiac issues during surgery
Benefits
- Relief from chronic pain
- Improved spinal alignment and posture
- Enhanced mobility and function
- Prevention of further spinal deformity progression
- Benefits may be noticed gradually over the weeks and months following surgery.
Recovery
- Post-operative hospital stay of approximately 5 to 7 days
- Pain management with prescribed medications
- Physical therapy to aid in recovery and regain strength
- Avoiding heavy lifting and strenuous activities for several months
- Follow-up appointments to monitor progress and ensure proper healing
Alternatives
- Non-surgical options like physical therapy, bracing, or pain management
- Less invasive surgical techniques
- Considerations: Non-surgical treatments may not provide the same level of correction or long-term relief.
Patient Experience
- Initially, patients may experience pain and discomfort managed with medications.
- Physical therapy will be necessary for recovery.
- Gradual improvement in pain and mobility, with restrictions on certain activities.
- Emotional support and counseling may help in coping with the recovery process.