CPT® Code 0790T

Revision (eg, augmentation, division of tether), replacement, or removal of thoracolumbar or lumbar vertebral body tethering, including thoracoscopy, when performed

The CPT® Code 0790T refers to the procedure involving the revision, replacement, or removal of thoracolumbar or lumbar vertebral body tethering (VBT). This procedure is particularly relevant for patients who have undergone previous VBT treatment, which is primarily utilized for managing adolescent idiopathic scoliosis. VBT serves as an alternative to traditional spinal fusion, allowing for the preservation of natural spinal growth and mobility. The procedure is specifically indicated for children and young adolescents who still possess sufficient growth potential. During the initial VBT procedure, small screws are inserted into the affected vertebrae, and a flexible cord, known as a tether, is placed to facilitate scoliosis correction. The tether is strategically tightened to compress the growth plates on the convex side of the spinal curve, thereby inhibiting growth in that area, while being loosened on the concave side to promote continued growth. As the patient matures, adjustments to the tether may be necessary to accommodate ongoing growth. Although revisions are infrequently required, occurring in fewer than 10% of cases, they may be necessary due to complications such as overcorrection, cord breakage, or dislodged screws. In such instances, the surgeon typically employs the same anterior approach utilized during the initial surgery, which may involve a mini-open thoracoabdominal exposure or a thoracoscopic technique to access the spine for the necessary corrections.