CPT® Code 61470

Deleted

CPT® Code 61470 refers to a surgical procedure known as a craniectomy, specifically a suboccipital craniectomy performed for the purpose of conducting a medullary tractotomy. A tractotomy is a neurosurgical intervention that involves the division or cutting of a nerve tract within the brain or spinal cord. This procedure is primarily indicated for the management of intractable pain, particularly nociceptive pain associated with conditions such as head and neck cancer. The medullary tractotomy aims to alleviate severe facial and neck pain by interrupting pain pathways in the brain. During the procedure, the patient is positioned sitting to optimize access to the medulla oblongata, which is the target area for intervention. The surgical approach involves creating a midline incision at the lower part of the skull to expose the occiput, followed by the creation of burr holes and a bone flap to access the medulla oblongata. This procedure is significant as it provides a means to achieve complete analgesia in the distribution of the trigeminal nerve and other cranial nerves, thereby addressing debilitating pain symptoms. It is important to note that while open tractotomy procedures like this one have been largely supplanted by less invasive techniques such as stereotactic tractotomy, they remain a critical option for certain patients with severe pain conditions.