Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (List separately in addition t
CPT4 code
Name of the Procedure:
Total Disc Arthroplasty (Artificial Disc), Anterior Approach, including Discectomy with End Plate Preparation (includes Osteophytectomy for Nerve Root or Spinal Cord Decompression and Microdissection); Second Level, Cervical
Summary
In total disc arthroplasty with an anterior approach, the damaged cervical disc is replaced with an artificial disc. The procedure involves removing the problematic disc and preparing the disc space to accommodate the new artificial disc to relieve nerve root or spinal cord compression.
Purpose
This procedure is designed to address cervical disc degeneration or other disc-related issues that cause neck pain and neurological symptoms. The goal is to relieve pain, restore normal disc function, and maintain mobility in the cervical spine.
Indications
Indicated for patients with symptomatic cervical disc degeneration, herniated discs, or spinal stenosis that have not responded to conservative treatments. Those experiencing severe neck pain, arm pain, or neurological deficits such as weakness or numbness may be candidates.
Preparation
- Pre-procedure instructions may include fasting for a specified period.
- Adjustments to medications, particularly blood thinners, as advised by the healthcare provider.
- Pre-procedure diagnostic tests such as MRI or CT scans to evaluate the cervical spine.
Procedure Description
- Anesthesia: General anesthesia is administered.
- Incision: A small incision is made in the front of the neck.
- Discectomy: The damaged cervical disc is removed.
- End Plate Preparation: The disc space is prepared, including removing any bone spurs.
- Artificial Disc Placement: The artificial disc is implanted into the prepared disc space.
- Closure: The incision is closed with sutures.
Tools and equipment used include surgical instruments for discectomy and implantation, and imaging technology for guidance.
Duration
The procedure typically takes 2-3 hours, depending on complexity.
Setting
Performed in a hospital or specialized surgical center.
Personnel
- Orthopedic or neurosurgeon
- Surgical nurses
- Anesthesiologist
- Surgical technologist
Risks and Complications
- Infection
- Bleeding
- Nerve injury
- Misplacement or failure of the artificial disc
- Persistent symptoms post-surgery
- Rare risk of paralysis
Benefits
- Relief from neck and arm pain
- Restoration of normal neck motion
- Improved quality of life, typically realized within weeks to months post-surgery.
Recovery
- Initial hospital stay: 1-2 days
- Pain management with prescribed medications
- Instructions on wound care and activity restrictions
- Physical therapy may be recommended
- Most patients resume regular activities within 6-12 weeks
Alternatives
- Conservative treatments: Physical therapy, medications, spinal injections
- Anterior cervical discectomy and fusion (ACDF)
- Pros and Cons: Alternatives may involve longer recovery times or reduced mobility compared to arthroplasty.
Patient Experience
Patients may experience discomfort, sore throat, or difficulty swallowing after the procedure. Pain is generally managed with medications, and comfort measures include neck support. Most patients report reduced pain and improved function as they heal.