22849 Reinsertion of spinal fixation device

Name of the Procedure:

Reinsertion of Spinal Fixation Device

Summary

Reinsertion of a spinal fixation device is a surgical procedure where previously placed hardware, such as screws, rods, or plates, is reinstalled to stabilize the spine. This may be necessary if the original implant failed, was placed incorrectly, or required adjustments for optimal spinal alignment.

Purpose

• Medical Condition/Problem: Addresses issues such as hardware failure, complications from initial surgery, or adjustments required for better spinal stability.
• Goals/Expected Outcomes: To restore stability to the spine, alleviate pain, improve function, and correct any issues related to the prior hardware.

Indications

• Symptoms or conditions like persistent pain, instability, or malfunction of existing hardware.
• Criteria such as evidence of hardware failure from imaging, ongoing spinal instability, or correction needs identified by a spine specialist.

Preparation

• Pre-procedure Instructions: Patients may need to fast for a certain period before surgery and may be advised to discontinue specific medications like blood thinners.
• Diagnostic Tests: Imaging studies such as X-rays, CT scans, or MRIs to assess current hardware placement and spine condition.

Procedure Description

1. Anesthesia: General anesthesia is typically administered.
2. Incision: A surgical incision is made at the site of the previous operation.
3. Removal of Old Hardware: The old hardware is carefully removed.
4. Reinsertion: New or adjusted hardware is installed to stabilize the spine.
5. Closure: The incision is closed with sutures or staples.

Tools include spinal fixation devices like screws, rods, plates, and specialized surgical instruments. Imaging technology such as fluoroscopy may be used to ensure correct placement.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity and extent of the reinsertion required.

Setting

The procedure is performed in a hospital operating room or surgical center.

Personnel

• Surgeon (particularly an orthopedic or neurosurgeon specializing in spine surgery)
• Surgical nurses
• Anesthesiologist
• Radiologic technologist (if imaging is needed during surgery)

Risks and Complications

• Common risks: Infection, bleeding, pain at the surgical site, or reactions to anesthesia.
• Rare risks: Nerve damage, blood clots, hardware failure, and complications requiring additional surgery.

Benefits

• Expected benefits include improved spinal stability, reduced pain, and enhanced mobility. Most patients begin to notice improvements within a few weeks post-surgery.

Recovery

• Post-Procedure Care: Pain management with medication, wound care, and instructions for physical activity restrictions.
• Recovery Time: Typically ranges from a few weeks to several months, depending on individual health factors and the extent of the procedure.
• Follow-up: Regular appointments for monitoring and possible physical therapy.

Alternatives

• Non-surgical options such as physical therapy, pain management techniques, or bracing.
• Pros and cons of alternatives vary; non-surgical treatments typically have fewer immediate risks but might not address instability as effectively as surgery.

Patient Experience

• During Procedure: Under general anesthesia, so the patient is unconscious and will not feel anything.
• After Procedure: Postoperative pain managed with medication, some discomfort and limited mobility initially. Care plans include pain management and support for returning to daily activities gradually.