CPT® Code 22214

An osteotomy of the spine is a surgical procedure that involves the removal of a portion of a vertebra to correct spinal deformities, particularly those that result in flexion deformities. This procedure is essential for realigning the affected vertebral segment, which can lead to improved spinal function, enhanced stability, and significant pain relief for the patient. The surgery is performed using a posterior or posterolateral approach, which entails making an incision directly over the targeted vertebral segment or just lateral to it. This approach allows the surgeon to access the spine effectively while minimizing damage to surrounding tissues.

During the procedure, the fascia covering the spine is incised, and a subperiosteal dissection is carried out along the spinal process, lamina, and both transverse processes, as well as the rib head of the vertebral segment, as necessary. A wedge of bone is then resected, which may also involve excising portions of the supraspinatus and infraspinatus ligaments and spinous processes. The surgical team carefully repositions the patient and applies manual pressure at the osteotomy site to facilitate the realignment of the vertebra, ensuring that nerve roots and other critical structures are kept under direct visualization to prevent any impingement during the manipulation of the vertebra. Once the bony gap created by the wedge resection is closed, additional stabilization may be achieved through separately reportable bone grafts and/or spinal instrumentation. To ensure proper healing and immobilization of the spine post-surgery, a body cast or jacket may be applied as needed.