CPT® Code 22207

Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar

A three-column osteotomy of the spine, commonly known as a pedicle subtraction osteotomy, is a surgical procedure performed on a single vertebral segment in the lumbar region using a posterior or posterolateral approach. The spine is anatomically divided into three columns: the anterior column, which consists of the vertebral body; the middle column, made up of two robust pedicles that encase the vertebral foramen through which the spinal cord traverses; and the posterior column, which includes the lamina, two transverse processes, and the spinous process. This type of osteotomy is typically indicated for addressing complex spinal deformities, particularly in the thoracic and lumbar regions, where it is essential to manipulate all three columns to achieve proper alignment and stability. The procedure involves making an incision in the skin over the affected vertebral segment, followed by careful dissection of the surrounding tissues to access the spine. The surgical technique requires precision to ensure that critical structures, such as the pedicles, are preserved while resecting the necessary components to correct the deformity. Intraoperative imaging is utilized to assess the correction of the deformity, ensuring that the surgical goals are met effectively.