63308 Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segment)

Name of the Procedure:

Vertebral Corpectomy (Vertebral Body Resection), Partial or Complete, for Excision of Intraspinal Lesion, Single Segment; Each Additional Segment (List separately in addition to codes for single segment)

Summary

A vertebral corpectomy is a surgical procedure where part or all of a vertebral body is removed. This technique is often utilized to excise an intraspinal lesion that is causing compression or other issues within the spine. If multiple segments need to be addressed, additional segments are treated individually.

Purpose

This procedure is performed to remove intraspinal lesions such as tumors or damaged tissue that compress the spinal cord or nerves. The main goal is to alleviate pain, restore nerve function, or prevent further neurological damage.

Indications

Patients might undergo this procedure if they have:

• Spinal tumors or metastatic cancer
• Spinal cord compression
• Severe spinal fractures
• Degenerative spine diseases unmanageable by other means

Preparation

• Patients may need to fast for a specific period before surgery.
• Medications might need adjustment; blood thinners commonly require cessation.
• Diagnostic imaging (e.g., MRI, CT scans) and blood tests are typically performed preoperatively.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made over the affected area of the spine.
3. Muscles and tissues are retracted to expose the vertebra.
4. Surgical instruments are used to remove part or all of the vertebral body.
5. The intraspinal lesion is excised.
6. If necessary, spinal stabilization using hardware or bone grafts is performed.
7. The incision is closed with sutures or staples.

Equipment used can include surgical drills, retractors, and imaging guidance systems.

Duration

The procedure typically lasts between 3 to 6 hours, depending on the complexity and number of segments involved.

Setting

This surgery is performed in a hospital operating room equipped for complex spinal surgeries.

Personnel

The surgical team includes:

• The primary spinal surgeon
• An assistant surgeon
• An anesthesiologist
• Surgical nurses
• A surgical technologist

Risks and Complications

Common risks:

• Bleeding
• Infection
• Spinal fluid leak

Rare risks:

• Unexpected spinal cord or nerve damage
• Hardware failure
• Chronic pain

Complications are managed through immediate post-operative care, monitoring, and sometimes additional surgeries.

Benefits

Expected benefits include pain relief, restored nerve function, and prevention of further neurological damage. Benefits are usually realized over weeks to months post-procedure.

Recovery

Post-operative care may include:

• Pain management using medications
• Physical therapy
• Limited movement and activity for several weeks
• Follow-up appointments to monitor healing and spinal alignment

Full recovery can take several months, depending on the extent of the surgery.

Alternatives

Alternative treatments might include:

• Radiation therapy for tumors
• Less invasive spinal decompression techniques
• Pain management and physical therapy

Each alternative has its pros and cons; for example, radiation is non-invasive but may not be effective for all lesions.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel anything. Post-procedure, there might be pain at the surgical site, which is managed with medications. Recovery involves gradual improvement in symptoms and physical rehabilitation to regain mobility and strength.