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Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Osteoplastic Reconstruction of Dorsal Spinal Elements

Summary

Osteoplastic reconstruction of dorsal spinal elements is a surgical procedure performed after a primary intraspinal surgery. It involves repairing and reconstructing the bony structures at the back of the spine to provide stability and support.

Purpose

This procedure addresses structural defects or damages in the spinal column resulting from primary spinal surgery. The goal is to restore the spine’s stability, reduce pain, and improve functional outcomes.

Indications

  • Spinal instability following primary intraspinal surgery
  • Structural damage to the dorsal spinal elements
  • Recurrent spinal deformities post-surgery
  • Chronic pain due to vertebral defects

Preparation

  • Patients may need to fast for a specific period before the surgery.
  • Adjustments to medications, particularly blood thinners, might be required.
  • Pre-procedure imaging tests like MRI or CT scans to assess the spine.

Procedure Description

  1. The patient is placed under general anesthesia.
  2. An incision is made along the spine to expose the affected area.
  3. The damaged or defective bony structures are carefully removed or reshaped.
  4. Reconstruction involves grafting bone or using synthetic materials to restore the spine’s anatomy.
  5. Metal hardware (screws, plates, rods) may be used to provide additional stability.
  6. The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically lasts 2 to 5 hours, depending on the complexity and extent of reconstruction required.

Setting

The procedure is performed in a hospital operating room or a dedicated surgical center.

Personnel

  • Orthopedic or neurosurgeon
  • Anesthesiologist
  • Surgical nurses
  • Surgical technicians

Risks and Complications

  • Infection
  • Bleeding
  • Nerve damage
  • Failure of bone graft or hardware
  • Chronic pain
  • Need for additional surgeries

Benefits

  • Improved spinal stability
  • Reduction in pain and discomfort
  • Enhanced mobility and quality of life
  • Prevention of further spinal deformities

Recovery

  • Hospital stay typically ranges from 2 to 7 days.
  • Pain management includes prescribed medications.
  • Physical therapy may be recommended to aid recovery.
  • Follow-up appointments to monitor healing and hardware integrity.
  • Restrictions on heavy lifting and strenuous activities for several weeks.

Alternatives

  • Non-surgical management such as bracing and physical therapy
  • Less invasive surgical techniques, if appropriate
  • Pain management strategies without surgical intervention

Patient Experience

During the procedure, patients are under general anesthesia and will not feel pain. Post-procedure, they might experience discomfort and pain which can be managed with medication. Recovery involves gradual improvement over several weeks with adherence to post-operative care instructions to ensure optimal healing and functionality.

Medical Policies and Guidelines for Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure)

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