Stereotactic computer-assisted (navigational) procedure; spinal (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Stereotactic Computer-Assisted (Navigational) Procedure; Spinal
Summary
The stereotactic computer-assisted procedure for the spine is an advanced surgical technique that uses computer-generated navigation to guide the surgeon with precise visualizations of the spinal structures. This enhances the accuracy and safety of spinal surgeries.
Purpose
This procedure is used to treat a variety of spinal conditions, such as herniated discs, spinal stenosis, and spinal tumors. The goal is to improve surgical precision, reduce complications, and enhance the overall outcome of spinal surgeries.
Indications
- Severe back or neck pain not relieved by conservative treatments
- Spinal deformities such as scoliosis or kyphosis
- Spinal instability due to trauma or degenerative conditions
- Spinal tumors or cysts
- Herniated discs causing nerve compression
Preparation
- Patients may need to fast for 8-12 hours before the procedure.
- Medication adjustments, particularly blood thinners, may be necessary.
- Pre-operative imaging tests such as MRI or CT scans are required to plan the surgery.
- Patients should arrange for someone to drive them home post-procedure.
Procedure Description
- Preoperative Planning: Detailed imaging of the spine is obtained and loaded into the computer navigation system.
- Anesthesia: General or regional anesthesia is administered.
- Patient Positioning: The patient is positioned on the surgical table, typically face down.
- Registration: The surgeon uses the computer navigation system to match the preoperative images with the actual anatomical landmarks of the patient.
- Surgical Access: Small incisions are made to access the spine.
- Navigation and Surgery: The surgeon uses real-time images from the navigation system to guide instruments and perform the necessary surgical tasks, such as removing a herniated disc or stabilizing vertebrae.
- Closure: The incisions are closed, and the patient is moved to recovery.
Duration
The procedure typically takes between 2 to 4 hours, depending on the complexity of the surgery.
Setting
This procedure is performed in a hospital or specialized surgical center equipped with the necessary technology.
Personnel
- Orthopedic surgeon or neurosurgeon
- Anesthesiologist
- Surgical nurses and support staff
- Radiologist or imaging technician
Risks and Complications
- Infection
- Bleeding
- Nerve injury leading to temporary or permanent deficits
- Hardware failure or displacement
- Blood clots
- Adverse reactions to anesthesia
Benefits
- Enhanced surgical precision
- Reduced risk of complications
- Smaller incisions leading to less postoperative pain
- Shorter hospital stay and quicker recovery time
- Better overall outcomes
Recovery
- Patients typically stay in the hospital for 1-3 days post-surgery.
- Pain management will involve medications and, in some cases, physical therapy.
- Restrictions on activities like lifting and bending are generally advised for several weeks.
- Follow-up appointments will be scheduled to monitor healing and progress.
Alternatives
- Traditional open spinal surgery
- Minimally invasive spinal surgery without computer assistance
- Non-surgical treatments such as physical therapy, pain management, and injections
- Each alternative has its own set of benefits and risks, and suitability varies by patient condition.
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel any pain. Post-procedure, the patient may experience discomfort at the surgical site, which will be managed with pain relief measures. Patients can expect a period of soreness and activity restrictions but should see improvement in their symptoms within a few weeks.