22851 Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) to vertebral defect or interspace (List separately in addition to code for primary procedure)

Name of the Procedure:

Application of Intervertebral Biomechanical Device(s) (e.g., synthetic cage(s), methylmethacrylate) to Vertebral Defect or Interspace

Summary

This procedure involves the placement of synthetic devices or materials between the vertebrae of the spine to support, stabilize, and alleviate pressure on the spine. It is often performed alongside a primary spinal surgery.

Purpose

• Medical Condition: Treatment of spinal instability, deformities, or damage due to conditions such as degenerative disc disease, fractures, or herniated discs.
• Goals: To stabilize the spine, alleviate pain, restore normal spinal alignment, and improve overall spinal function.

Indications

• Severe back pain not relieved by conservative treatments.
• Diagnosed spinal instability or deformity.
• Vertebral fractures or disc herniations causing nerve compression.
• Failed previous spinal surgeries needing correction.

Preparation

• Pre-Procedure Instructions: Patients may be advised to fast for a certain period before the procedure and might need to discontinue specific medications as instructed by their healthcare provider.
• Diagnostic Tests: MRI, CT scans, or X-rays to assess the condition of the spine and plan the intervention.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free during the procedure.
2. Incision: A surgical incision is made at the targeted area of the spine.
3. Preparation of the Site: The vertebrae and disc space are carefully accessed, and any necessary removal or preparation of damaged disc material is conducted.
4. Placement of Device: The intervertebral biomechanical device or synthetic material is positioned between the vertebrae.
5. Closure: The incision is closed with sutures, and the area is bandaged.

• Tools and Equipment: Surgical instruments, synthetic cages, methylmethacrylate, imaging tools for guidance.

Duration

The procedure typically takes between 2 to 5 hours, depending on the extent of the surgery and the complexity of the case.

Setting

The procedure is performed in a hospital setting, specifically in an operating room designed for spinal surgeries.

Personnel

• Orthopedic surgeon or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common Risks: Infection, bleeding, and reaction to anesthesia.
• Rare Risks: Nerve damage, implant failure, blood clots, and chronic pain. Management involves appropriate medical interventions and sometimes additional surgery.

Benefits

• Stabilization of the spine.
• Pain relief typically within a few weeks following the procedure.
• Improved mobility and functional outcomes.

Recovery

• Immediate Post-Procedure: Hospital stay of a few days to monitor recovery.
• Post-Procedure Care: Pain management with medications, limited physical activity, and guidance from a physical therapist.
• Recovery Time: Recovery can take several weeks to months with gradual return to normal activities. Follow-up appointments are essential to monitor healing.

Alternatives

• Conservative Treatments: Physical therapy, medications, spinal injections.
• Other Surgical Options: Spinal fusion or disc replacement.
• Pros and Cons: Conservative treatments are less invasive but may not provide long-term relief. Alternative surgeries might offer different mobility outcomes but carry similar risks.

Patient Experience

• During Procedure: The patient will be under general anesthesia and will not feel any part of the surgery.
• After Procedure: Some discomfort and pain management will be necessary. Patients may experience soreness, stiffness, and need assistance in the initial recovery phase.
• Pain Management: Medications and physical therapy will be prescribed to help manage pain and aid recovery.