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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
- The patient is given general anesthesia.
- An incision is made in the front of the neck to expose the cervical spine.
- Surgeons remove part or all of the affected vertebral body (corpectomy).
- Decompression of the spinal cord and/or nerve roots is achieved.
- A bone graft or a spinal implant may be inserted to stabilize the spine.
- 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.