CPT® Code 63051

Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)

Cervical laminoplasty is a surgical procedure designed to alleviate spinal stenosis, a condition characterized by the narrowing of the spinal canal that can lead to pressure on the spinal cord. The primary objective of this procedure is to relieve this pressure while ensuring the posterior stability of the spine. The technique involves a unique approach where the bony posterior elements of the spine are partially cut on one side to create a hinge, while the opposite side undergoes a complete cut to form a partially opened door. This method allows for the effective decompression of the spinal cord. The procedure begins with a posterior incision over the cervical spine, followed by the retraction of the paraspinous muscles to expose the laminae, spinous processes, and facet joints of the affected vertebral bodies. A complete osteotomy is performed on the side designated to form the open door, and the ligamentum flavum is divided to facilitate access. On the contralateral side, a hinge is created by scoring the vertebrae at the junction of the facet and lamina, allowing for the opening of the side that has undergone complete osteotomy. This action relieves the pressure on the spinal cord effectively. Unlike CPT® code 63050, which does not include the reconstruction of the bony elements, CPT® code 63051 encompasses the reconstruction process, which involves the application of bone grafts and/or non-segmental fixation devices to secure the newly created space. The bone grafts, whether allografts or autografts, are tailored to fit the bony defects and are placed into the vertebrae to maintain the opening. Fixation devices such as wire, suture, or mini-plates are then utilized as necessary to ensure the stability of the grafts. Finally, the surgical wound is meticulously closed in layers to promote optimal healing.