63621 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure)

Name of the Procedure:

Stereotactic Radiosurgery (SRS) for Spinal Lesions

• Common Names: SRS, Gamma Knife surgery, CyberKnife treatment
• Medical Terms: Particle beam therapy, Linear accelerator (LINAC) radiosurgery

Summary

Stereotactic radiosurgery (SRS) is a non-surgical radiation therapy used to treat abnormalities, tumors, and lesions in the spine. It involves delivering precisely-targeted radiation in fewer high-dose treatments compared to traditional therapy, preserving surrounding healthy tissue.

Purpose

Medical Condition: Primarily used for treating cancerous spinal lesions, metastases, and certain benign tumors. Goals: To destroy or shrink the spinal lesions, alleviate pain, and improve spinal function while minimizing radiation exposure to healthy tissues.

Indications

• Presence of primary or metastatic spinal tumors
• Persistent pain or neurological deficits caused by spinal lesions
• Patients who are not good candidates for conventional surgery

Preparation

• Fasting may be required for a few hours before the procedure.
• Patients should follow specific medication adjustments as instructed by their physician.
• Pre-procedure imaging tests such as MRI or CT scans are required to map the exact location of the lesions.

Procedure Description

• The patient is positioned comfortably, and their spine is stabilized.
• Detailed imaging guides the precise targeting of radiation.
• Depending on the system used (Gamma Knife, CyberKnife, or LINAC), computer software plans the radiation dose.
• Focused beams of radiation are delivered to the spinal lesion.
• No incisions are made, and the procedure is typically non-invasive.
• Sedation or anesthesia details depend on patient comfort and the specific system used.

Duration

• Each treatment session typically lasts 30 minutes to 2 hours.

Setting

• Performed in specialized medical facilities such as hospitals or outpatient clinics equipped with advanced radiotherapy technology.

Personnel

• Radiation oncologist
• Neurosurgeon
• Medical physicist
• Radiation therapist
• Nursing staff

Risks and Complications

Common Risks:

• Fatigue
• Skin irritation in the treated area Rare Risks:
• Radiation injury to surrounding tissues
• Spinal cord or nerve damage
• Potential worsening of symptoms

Benefits

• Non-invasive and generally well-tolerated
• Precise targeting minimizes damage to healthy tissue
• Usually, fewer sessions are required compared to conventional radiation therapy
• Pain relief and control of tumor growth within weeks

Recovery

• Patients can often go home the same day.
• Mild discomfort or fatigue may occur and typically resolves quickly.
• Follow-up imaging and appointments to monitor the treatment's effectiveness.

Alternatives

• Open spinal surgery
• Conventional external beam radiation therapy
• Chemotherapy Pros and Cons:
• Conventional surgery may offer immediate removal but carries higher risk and longer recovery.
• Chemotherapy affects the whole body and has systemic side effects, unlike localized SRS.

Patient Experience

• The procedure is generally painless, but lying still for an extended period may cause discomfort.
• Pain management and comfort measures are provided.
• Post-procedure, you may feel tired, but normal activities can usually resume within a day or two with some limitations depending on your doctor's advice.

This comprehensive yet concise overview aims to help patients understand what to expect from stereotactic radiosurgery for spinal lesions.