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Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure)
CPT4 code
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.