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Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment

CPT4 code

Name of the Procedure:

Vertebral Corpectomy (Vertebral Body Resection), Partial or Complete, Anterior Approach with Decompression of Spinal Cord and/or Nerve Root(s); Cervical, Single Segment

Summary

A vertebral corpectomy is a surgical procedure where part or all of a cervical vertebral body is removed through an incision in the front of the neck. This is done to relieve pressure on the spinal cord and/or nerve roots caused by conditions affecting the spine.

Purpose

Medical Condition
  • Spinal cord compression
  • Nerve root compression
  • Degenerative disc disease
  • Spinal fractures
  • Tumors
  • Infections
Goals/Outcomes
  • Alleviate pain
  • Restore neurological function
  • Stabilize the spine
  • Prevent further spinal cord or nerve damage

Indications

Symptoms/Conditions
  • Persistent neck pain
  • Radiating pain in arms or shoulders
  • Weakness or numbness in limbs
  • Loss of fine motor skills
  • Difficulty walking
Patient Criteria
  • Patients with confirmed compression of the spinal cord or nerves via MRI or CT scans
  • Patients who have not responded to conservative treatments (e.g., physical therapy, medications)

Preparation

Pre-Procedure Instructions
  • Fasting for at least 8 hours before surgery
  • Adjustments to current medications, especially blood thinners
  • Preoperative blood tests and imaging studies (MRI, CT scans)

Procedure Description

  1. The patient is given general anesthesia.
  2. An incision is made in the front of the neck to expose the cervical spine.
  3. Surgeons remove part or all of the affected vertebral body (corpectomy).
  4. Decompression of the spinal cord and/or nerve roots is achieved.
  5. A bone graft or a spinal implant may be inserted to stabilize the spine.
  6. The incision is closed with sutures or staples.
Tools/Equipment
  • Surgical instruments for cutting and removing bone
  • Spinal implants or bone graft materials
  • Imaging guidance systems
  • Anesthesia equipment

Duration

The procedure typically takes 3 to 5 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

  • Orthopedic or neurosurgeon
  • Anesthesiologist
  • Operating room nurses
  • Surgical technologists

Risks and Complications

Common Risks
  • Infection
  • Bleeding
  • Injury to spinal cord or nerves
Rare Risks
  • Blood clots
  • Failure of bone graft or implant
  • Persistent pain or neurological deficits
Management
  • Post-operative antibiotics
  • Pain management strategies
  • Physical therapy

Benefits

  • Relief from pain and neurological symptoms
  • Improved spine stability
  • Enhanced quality of life
Realization Time
  • Some relief may be immediate; full benefits often realized within weeks to months

Recovery

Post-Procedure Care
  • Hospital stay of 2-4 days
  • Physical therapy initiation
  • Pain management with prescribed medications
Recovery Time
  • Full recovery may take 6-12 weeks
  • Activity restrictions, such as avoiding heavy lifting
Follow-up
  • Regular follow-up appointments to monitor healing and adjust treatment as necessary

Alternatives

Treatment Options
  • Conservative treatments (physical therapy, pain medications)
  • Spinal fusion
  • Laminectomy
Pros and Cons
  • Conservative treatments have fewer risks but may be less effective.
  • Spinal fusion and laminectomy are alternative surgical options with different indications and outcomes.

Patient Experience

During Procedure
  • The patient will be under general anesthesia and will feel no pain during the surgery.
After Procedure
  • Initial discomfort and soreness at the incision site
  • Pain management with medications
  • Gradual return to normal activities under physician guidance

Pain and discomfort are managed with medications, and most patients can begin to move with assistance shortly after surgery. Physical therapy plays a crucial role in recovery.

Medical Policies and Guidelines for Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment

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