Repair of meningocele; larger than 5 cm diameter
CPT4 code
Name of the Procedure:
Repair of Meningocele; Larger than 5 cm Diameter
Summary
In layman's terms, this procedure involves surgically correcting a meningocele—a type of spinal defect—when it is larger than 5 cm in diameter. The meningocele involves an abnormal sac protruding from the spinal column containing spinal fluid and meninges (the protective coverings of the spinal cord).
Purpose
The procedure addresses meningocele, a condition most often present at birth. The goals are to close the gap in the spine, prevent infection and further nerve damage, and improve the patient's mobility and function.
Indications
- Presence of a meningocele larger than 5 cm in diameter.
- Symptoms such as fluid leakage, infection, or nerve damage causing functional impairments.
- Potential or actual neurological deficits.
- Cosmetic concerns due to the large size of the meningocele.
Preparation
- Patients typically need to fast for at least 8 hours prior to surgery.
- Medication adjustments may be required; specific instructions provided by the healthcare team.
- Diagnostic tests like MRI or CT scans to assess the extent of the defect.
- Blood tests and other routine preoperative assessments.
Procedure Description
- Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
- Incision: A surgical incision is made over the meningocele.
- Exposure: The sac containing cerebrospinal fluid is carefully exposed.
- Repair: The surgeon removes the meningocele sac and repairs the surrounding tissues and membranes.
- Closure: The incision is closed with sutures, and a sterile dressing is applied.
- Drain Placement: In some cases, drains may be placed to remove excess fluids postoperatively.
Tools include surgical scalpels, retractors, sutures, and possible use of microsurgical instruments.
Duration
The procedure typically takes 2 to 4 hours, depending on the complexity.
Setting
The procedure is performed in a hospital surgical suite.
Personnel
- Surgeon (usually a neurosurgeon or pediatric surgeon)
- Surgical nurses
- Anesthesiologist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Nerve damage
- Leakage of cerebrospinal fluid
- Anesthesia-related complications
Benefits
- Prevention of infection and further neurological damage.
- Improved neurological function and mobility.
- Reduction or elimination of symptoms related to meningocele.
- Enhanced aesthetic appearance in the affected area.
Recovery
- Initial hospital stay of 3 to 7 days post-procedure.
- Pain management with medications.
- Instructions for wound care.
- Restricted physical activity for several weeks.
- Follow-up appointments for monitoring and removal of sutures or drains.
Alternatives
- Observation and conservative management: Generally not recommended for large meningoceles due to risk of complications.
- Shunt placement: Sometimes used in conjunction with repair to manage hydrocephalus if present.
- Other neurosurgical interventions based on individual patient factors.
Patient Experience
- Patients will be under general anesthesia and will not feel anything during the procedure.
- Postoperative pain and discomfort managed with pain relief medications.
- Gradual improvement in symptoms and function as healing progresses.
- Regular follow-up care to monitor progress and address any complications.