22843 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in addition to code for primary procedure)

Name of the Procedure:

Posterior Segmental Instrumentation (e.g., Pedicle Fixation, Dual Rods with Multiple Hooks and Sublaminar Wires); 7 to 12 Vertebral Segments

Summary

Posterior segmental instrumentation is a type of spine surgery that involves stabilizing a section of the spine using hardware like rods, hooks, and wires. This procedure specifically targets 7 to 12 vertebral segments to correct or support the spinal column.

Purpose

The procedure aims to address instability, deformities, or damage within the spine. Conditions treated include scoliosis, spinal fractures, and degenerative spinal diseases. The goal is to stabilize the spine, reduce pain, and improve function and alignment.

Indications

• Scoliosis or other spinal deformities
• Spinal fractures
• Degenerative disc disease
• Spondylosis
• Spinal instability
• Failed previous spinal surgeries

Patient criteria may include persistent symptoms despite conservative treatment, significant spinal curvature, or progressive deformities.

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Adjustments to current medications, particularly blood thinners, may be required.
• Pre-operative diagnostic tests may include X-rays, MRI, or CT scans to assess the spine.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made along the back to expose the spine.
3. The surgeon places screws into the pedicles of the vertebrae.
4. Rods are inserted and connected to the screws to stabilize the spine.
5. Hooks and sublaminar wires may be added for additional support.
6. The hardware is secured, and the incision is closed. Tools used include pedicle screws, rods, hooks, and sublaminar wires. General anesthesia ensures the patient is unconscious and pain-free during the surgery.

Duration

The procedure typically lasts 4 to 6 hours, depending on the complexity.

Setting

The procedure is performed in a hospital's operating room.

Personnel

• Spine Surgeon
• Surgical Assistants
• Anesthesiologist
• Operating Room Nurses

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Hardware failure or migration
• Chronic pain
• Blood clots
• Delayed healing or non-union

Benefits

• Improved spinal stability and alignment
• Pain reduction
• Enhanced physical function
• Prevents further spinal degradation Benefits can often be realized within weeks to months post-surgery.

Recovery

• Initial hospital stay of 3 to 7 days.
• Pain management, possibly including medications.
• Physical therapy may begin shortly after surgery.
• Follow-up appointments to monitor healing and hardware position.
• Full recovery may take several months, with restrictions on heavy lifting or twisting.

Alternatives

• Conservative treatments like physical therapy or bracing.
• Anterior spinal fusion.
• Non-surgical pain management techniques. Pros and cons of alternatives vary; conservative methods are less invasive but may be less effective for severe cases.

Patient Experience

Patients should expect general anesthesia during the procedure, followed by soreness and pain at the surgical site. Postoperative pain management, including medication and physical therapy, helps ensure comfort and aids recovery.