CPT® Code 22318

Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting

The procedure described by CPT® Code 22318 involves the open treatment and/or reduction of odontoid fractures and/or dislocations, which may include conditions such as os odontoideum. The odontoid process is a critical anatomical structure that resembles a tooth and is located on the second cervical vertebra, known as the axis. This procedure is performed using an anterior approach, meaning that the incision is made from the front of the neck. Internal fixation is utilized to stabilize the fracture or dislocation, ensuring proper alignment and healing of the cervical spine. The procedure is performed without the need for bone grafting, distinguishing it from similar procedures that may require additional grafting material to promote healing. The surgical approach necessitates careful dissection to avoid vital structures such as the carotid artery, trachea, and esophagus, highlighting the complexity and precision required in this operation. The use of guide wires during the procedure aids in the stabilization of the affected area, and post-operative care may include the placement of a drain to manage any potential fluid accumulation. This comprehensive approach aims to restore the integrity of the cervical spine and alleviate any associated symptoms resulting from the fracture or dislocation.