Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
CPT4 code
Name of the Procedure:
Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
Summary
This surgical procedure involves placing a stabilization or distraction device between the vertebrae in the lower back (lumbar region) to alleviate pressure on the spinal nerves. It does not involve spinal fusion and includes the use of imaging technology for precise placement, as well as decompression to relieve nerve pressure.
Purpose
The procedure aims to treat conditions associated with spinal stenosis, such as chronic back pain, leg pain, and reduced mobility. The goal is to stabilize the spine, alleviate nerve pressure, and improve the patient's quality of life without the need for spinal fusion.
Indications
- Chronic lower back pain unresponsive to conservative treatments.
- Symptoms of lumbar spinal stenosis, including leg pain and numbness.
- Patients who are not good candidates for spinal fusion.
- Presence of neurogenic claudication (pain and discomfort in the legs due to nerve compression).
Preparation
- Patients may need to fast for several hours prior to the procedure.
- Medication adjustments, including stopping blood thinners.
- Preoperative imaging studies, such as MRI or CT scans, to plan the surgery.
- Routine blood tests and physical examinations.
Procedure Description
The surgeon will make a small incision in the lower back to access the spine. Using image guidance technology, the interlaminar/interspinous process stabilization/distraction device is accurately positioned between the vertebrae. Open decompression may involve the removal of some bone or tissue to relieve pressure on the spinal nerves. Throughout the procedure, the patient is under general anesthesia.
Duration
The procedure typically takes about 1 to 2 hours, depending on the complexity and specifics of the patient's condition.
Setting
This procedure is performed in a hospital or a specialized surgical center equipped with necessary imaging technology.
Personnel
- Orthopedic or neurosurgeon
- Anesthesiologist
- Surgical nurses
- Radiology technician for image guidance
Risks and Complications
- Infection at the surgical site
- Bleeding or blood clots
- Nerve damage
- Device migration or failure
- Adverse reactions to anesthesia
- Persistent pain or recurrence of symptoms
Benefits
- Reduction or elimination of pain and discomfort in the lower back and legs.
- Improved mobility and functionality.
- Shorter recovery time compared to spinal fusion surgery.
- Minimally invasive approach reduces tissue damage and scarring.
Recovery
- Initial hospital stay of 1 to 2 days.
- Pain management including medications.
- Gradual return to normal activities over several weeks.
- Follow-up appointments for monitoring progress and ensuring proper healing.
Alternatives
- Physical therapy and pain management.
- Epidural steroid injections.
- Minimally invasive decompression procedures.
- Spinal fusion, though it involves a longer recovery and greater impact on spinal mobility.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel pain. Post-procedure, there may be some discomfort, which is managed with medications. Patients will receive guidelines for wound care, activity restrictions, and will likely need physical therapy to aid recovery. Most patients can expect significant pain relief and improved mobility within a few weeks to months post-surgery.