Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical
CPT4 code
Name of the Procedure:
Laminotomy (hemilaminectomy) with decompression of nerve root(s), including partial facetectomy, foraminotomy, and/or excision of herniated intervertebral disc; 1 interspace, cervical.
Summary
In layman's terms, this surgical procedure involves removing part of a vertebra in the neck area to relieve pressure on the nerve roots or spinal cord. This can also involve removing part of the facet joint, enlarging the space where the nerve exits the spine, and removing a herniated disc if necessary.
Purpose
The purpose of this procedure is to alleviate pain, numbness, weakness, or other symptoms caused by pressure on the spinal nerves or spinal cord in the cervical region. The goal is to improve mobility and quality of life.
Indications
- Persistent neck pain radiating down the arm
- Numbness or weakness in the arms or hands
- Cervical disc herniation
- Spinal stenosis (narrowing of the spinal canal)
- Degenerative disc disease
- Symptoms not responding to conservative treatments like physical therapy or medication
Preparation
- Fast for at least 8 hours before the procedure
- Adjust or stop certain medications as directed by the physician
- Complete necessary diagnostic tests such as MRI or CT scans
- Discuss medical history and any allergies with the healthcare team
Procedure Description
- Anesthesia: Administered general anesthesia to ensure the patient is asleep and pain-free.
- Incision: A small incision is made in the back of the neck.
- Laminotomy: Removal of part of the vertebra (lamina) to access the spinal canal.
- Decompression: Identifying and relieving pressure on the affected nerve roots or spinal cord by removing bone, ligament, or disc material.
- Closure: The incision is closed with sutures or staples.
- Recovery: Patient taken to a recovery area to awaken from anesthesia.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The procedure is performed in a hospital or a surgical center.
Personnel
- Orthopedic or Neurosurgeon
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Infection
- Bleeding
- Nerve damage or spinal cord injury
- Dural tear leading to spinal fluid leak
- Persistent or recurring symptoms
- Reaction to anesthesia
Benefits
- Relief from chronic pain, numbness, and weakness
- Improved neck mobility and function
- Enhanced quality of life
- Reduction in use of pain medications
Recovery
- Hospital stay for 1-2 days or outpatient discharge the same day, depending on the individual case.
- Pain management with prescribed medications
- Instructions to avoid strenuous activities for several weeks
- Physical therapy to aid in recovery
- Follow-up appointments to monitor progress
Alternatives
- Conservative treatments such as physical therapy, medications, or epidural injections
- Other surgical options like spinal fusion or full laminectomy
- Each alternative has its own pros and cons regarding invasiveness, recovery time, and success rates.
Patient Experience
- During the procedure, the patient will be under general anesthesia and will not feel anything.
- Post-procedure, there might be discomfort or pain at the surgical site, managed with pain relief measures.
- Gradual improvement in symptoms over weeks to months.
- Physical therapy to help regain strength and mobility.
- Regular follow-up to ensure proper healing and tackle any arising issues.