63090 Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment

Name of the Procedure:

Vertebral Corpectomy (Vertebral Body Resection), Partial or Complete, Transperitoneal or Retroperitoneal Approach with Decompression of Spinal Cord, Cauda Equina or Nerve Root(s), Lower Thoracic, Lumbar, or Sacral; Single Segment

Summary

In a vertebral corpectomy, part or all of a vertebral body in the spine is surgically removed to relieve pressure on the spinal cord, cauda equina, or nerve roots. The surgery can be accessed through the abdomen (transperitoneal) or the back (retroperitoneal).

Purpose

The primary goal of this procedure is to decompress (remove pressure from) the spinal cord, cauda equina, or nerve roots to alleviate pain, restore function, and prevent further neurological damage.

Indications

• Severe back pain unresponsive to other treatments.
• Neurological deficits such as weakness, numbness, or paralysis.
• Spinal tumors, fractures, or infections affecting the lower thoracic, lumbar, or sacral vertebrae.
• Spinal stenosis or degenerative disc disease causing significant nerve compression.

Preparation

• Fasting for at least 8 hours before surgery.
• Discontinuing certain medications as directed (e.g., blood thinners).
• Pre-operative imaging studies such as MRI, CT scans, or X-rays.
• General health checks including blood tests and possibly an EKG.

Procedure Description

1. The patient is positioned and given general anesthesia.
2. An incision is made either through the abdomen (transperitoneal) or the back (retroperitoneal).
3. The muscles and tissues are carefully retracted to expose the vertebrae.
4. The affected vertebral body is partially or completely removed.
5. Decompression is performed on the spinal cord, cauda equina, or nerve roots.
6. Any necessary reconstruction, such as inserting a bone graft or metal hardware, is done to provide stability.
7. The incision is closed, and the patient is moved to the recovery area.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Orthopedic or neurosurgeon.
• Surgical nurses and technicians.
• Anesthesiologist.
• Radiology technician (if intraoperative imaging is used).

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Nerve damage leading to numbness, weakness, or paralysis.
• Complications from anesthesia.
• Spinal instability requiring further surgery.

Benefits

• Relief from chronic back pain.
• Improved neurological function and mobility.
• Prevention of further spinal damage or deformity. Improvements can often be noticed within a few weeks to months, depending on individual recovery.

Recovery

• Post-operative care in the hospital for a few days.
• Pain management with medications.
• Physical therapy to aid in recovery and strengthen muscles.
• Restrictions on heavy lifting and strenuous activities for several weeks.
• Follow-up appointments to monitor healing and outcome.

Alternatives

• Non-surgical treatments including physical therapy, pain management, and spinal injections.
• Less invasive surgical options like laminectomy or discectomy.
• Each alternative has its own risks and benefits which should be discussed with the healthcare provider.

Patient Experience

• During the procedure, the patient is under general anesthesia and will not feel anything.
• Post-surgery, pain and discomfort are managed with medications.
• Gradual improvement in mobility and pain relief as healing progresses, with support from physical rehabilitation.

This markdown text provides a comprehensive overview of the vertebral corpectomy procedure, suitable for informing patients or healthcare professionals.