CPT® Code 22532

Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic

Arthrodesis by lateral extracavitary technique, including minimal discectomy to prepare the interspace (other than for decompression), is a surgical procedure aimed at fusing vertebral segments in the thoracic spine. This technique involves a lateral approach that necessitates the resection of ribs and exposure of the pleura and/or peritoneum, allowing for direct access to the spinal column. The procedure begins with a midline incision that is extended laterally to reveal the paraspinous muscle bundle over the targeted thoracic or lumbar vertebral segment. The paraspinous muscles are carefully elevated off the spinous processes and laminae to facilitate access to the underlying structures. During the operation, the paraspinous muscle bundle is divided and elevated off the ribs, which are then dissected from the intercostal muscles and pleura. The rib is resected, and the intercostal nerve is identified and protected to prevent damage. A high-speed drill is utilized to remove the associated transverse process and the lateral portion of the facet and pedicle, exposing the dural sac and vertebral body. In cases involving the lumbar spine, the peritoneum is also exposed and retracted to enhance visibility of the vertebral body. The procedure includes the removal of degenerated disc material to prepare the interspace for arthrodesis, followed by the decortication of the vertebral endplates. To facilitate the interbody arthrodesis, a separately reportable bone allograft or autograft is placed between the vertebral endplates. After the necessary interventions, drains may be placed as needed, and the incisions are subsequently closed. This comprehensive approach ensures that the vertebral segments are adequately prepared for fusion, promoting stability and recovery in the thoracic spine.