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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.

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

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