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Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Anterior Instrumentation; 8 or More Vertebral Segments

Summary

Anterior instrumentation is a surgical procedure used to stabilize the spine by attaching rods, screws, or plates to the front (anterior) part of the vertebral column. This specific procedure involves the instrumentation of 8 or more vertebral segments.

Purpose

Anterior instrumentation aims to treat spinal deformities, instability, or fractures. It helps in correcting spinal alignment and providing stability to the spinal column.

Indications

  • Spinal deformities such as scoliosis or kyphosis
  • Vertebral fractures
  • Spinal instability due to conditions like tumors or infections
  • Degenerative spinal diseases causing significant instability

Preparation

  • Fasting for at least 8 hours before the procedure
  • Adjusting or discontinuing certain medications as advised by the doctor
  • Pre-operative imaging studies like X-rays, MRI, or CT scans

Procedure Description

  1. The patient is given general anesthesia.
  2. An incision is made on the side or front of the body to access the spine.
  3. The surgeon exposes the vertebral segments needing instrumentation.
  4. Rods, screws, or plates are placed on the anterior part of the spine to stabilize it.
  5. The hardware is secured, and the incision is closed with sutures or staples.

Duration

The procedure typically takes 4-6 hours, depending on the complexity and the number of vertebral segments treated.

Setting

Performed in a hospital operating room.

Personnel

  • Orthopedic or neurosurgeon
  • Anesthesiologist
  • Surgical nurses
  • Radiology technicians (if intraoperative imaging is required)

Risks and Complications

  • Infection
  • Bleeding
  • Nerve damage
  • Hardware failure or displacement
  • Blood clots
  • Complications from anesthesia

Benefits

  • Improved spinal stability and alignment
  • Reduced pain associated with instability or deformity
  • Enhanced quality of life and ability to perform daily activities

Recovery

  • Hospital stay for 3-7 days
  • Pain management with medications
  • Physical therapy to regain strength and mobility
  • Restrictions on certain activities for several weeks to months
  • Follow-up appointments for monitoring progress and hardware placement

Alternatives

  • Posterior spinal instrumentation
  • Non-surgical treatments like physical therapy, bracing, or medications
  • Minimally invasive spinal procedures

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-operatively, patients may experience discomfort, which is managed with pain medications. Physical therapy and gradual return to normal activities are key parts of recovery.

Medical Policies and Guidelines for Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure)

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