CPT® Code 22861

The procedure described by CPT® Code 22861 involves the revision and replacement of a total disc arthroplasty, specifically targeting the cervical spine through an anterior approach. This surgical intervention is typically performed when there are complications associated with a previously implanted artificial disc, which may include persistent pain, degenerative changes in the surrounding vertebrae, or misalignment of the spine at the treated or adjacent disc levels. The operation begins with an incision made in the front of the neck, positioned slightly off the midline to provide optimal access to the cervical spine. During the procedure, the esophagus is carefully retracted to prevent injury, and critical structures such as nerves and arteries are identified and safeguarded. The soft tissues of the neck are meticulously dissected to expose the spine, allowing for the retraction of intervertebral muscles to reveal the artificial disc. The existing disc is then removed, and the condition of the vertebral bodies is assessed for any bone loss or damage. If feasible, the disc space is prepared for the insertion of a new artificial disc, which involves milling and shaping the end plates to ensure a proper fit. The procedure emphasizes maintaining the natural curvature of the cervical spine while securing the new disc in place, followed by the closure of incisions and potential placement of a temporary drain to manage postoperative fluid accumulation.