CPT® Code 22633

Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;

The procedure described by CPT® Code 22633 involves arthrodesis, which is a surgical fusion of the lumbar vertebral joints. This technique is specifically utilized to address conditions such as fractures or instability within the lumbar spine. The procedure employs a combined posterior or posterolateral approach along with a posterior interbody technique. This means that the surgery is performed from the back of the patient, allowing access to the lumbar vertebrae. An incision is made in the lower back, and the surrounding soft tissues are carefully dissected to expose the affected vertebrae. A portion of the lamina, which is a part of the vertebral arch, is removed using a bone drill to prepare the intervertebral space for fusion. During the procedure, the intervertebral disc is excised, and the joint space is meticulously prepared for arthrodesis. This preparation may involve additional steps such as the treatment of any fractures or decompression, which can be reported separately if performed. The surgical team prepares the transverse processes, facet joints, and/or laminae for the placement of bone grafts, which are essential for achieving successful fusion. Bone grafts can be harvested from the patient's iliac crest or other donor sites, and allograft bone from a bone bank may also be utilized. The graft is then placed in the intervertebral joint space to promote the fusion of the vertebral bodies. To enhance stability, additional bone graft material may be applied to other areas of the vertebral joint, including the transverse processes, facet joints, or laminae. The procedure may also involve creating drill holes in the facets or spinous processes of each vertebra, through which wires can be threaded to immobilize the joint. Alternatively, other internal fixation devices, which are separately reportable, may be inserted through the pedicles or facets to provide additional support. After the surgical intervention, a drain may be placed to prevent fluid accumulation, and the surgical wound is closed in layers. This comprehensive approach ensures that the fusion of a single interspace of the lumbar spine is effectively achieved, as indicated by the use of CPT® Code 22633.