CPT® Code 22862

The procedure described by CPT® Code 22862 involves the revision and replacement of a total disc arthroplasty, specifically through an anterior approach at a single interspace in the lumbar region of the spine. This surgical intervention is typically necessitated by various factors, including persistent pain, degenerative changes in the spine, or misalignment of the spine at the previously treated or adjacent disc spaces. During the procedure, the surgeon makes an incision in the abdomen to access the lumbar spine. The intervertebral muscles are carefully retracted to expose the existing artificial disc. The surgeon then dissects the artificial disc from the end plates of the vertebrae and removes it, while assessing any bone loss or damage to the vertebral bodies. If the conditions allow for a new disc to be placed, the disc space is meticulously prepared by milling and shaping the end plates above and below the interspace to accommodate the new artificial disc. Tension is applied to the vertebral bodies to facilitate the opening of the disc space, allowing for the insertion of the new artificial disc. The new disc, which consists of two metal plates surrounding a polyurethane core and saline cushion, is then positioned into the prepared space, ensuring that the normal curvature of the spine is maintained. In cases where replacement is necessary, the failed implant is removed, and the interspace is explored and prepared for the insertion of a new prosthesis or component. Finally, the fascia and muscle tissue are repaired, and the surgical wound is closed, often with a drain left in place to prevent fluid accumulation.