CPT® Code 63185

Laminectomy with rhizotomy, as described by CPT® Code 63185, is a surgical procedure aimed at alleviating spasticity that has not responded to conservative treatments, including oral medications and less invasive interventions such as facet joint or nerve root injections of botulinum toxin, phenol, or alcohol. Rhizotomy specifically targets the nerve rootlets responsible for spasticity, which is often seen in conditions like cerebral palsy, particularly affecting the lower extremities. The procedure begins with an incision over the spine in the area designated for the rhizotomy, extending down to the spinous processes to provide adequate access. Following this, muscle tissue is carefully retracted to expose the lamina and facet joint. A bone drill is utilized to remove part or all of the lamina, allowing for the exposure of the spinal cord and nerve roots. During the procedure, electrical stimulation is applied to individual nerve rootlets to accurately identify the motor nerve rootlets contributing to the spasticity, which are then selectively cut to relieve the symptoms. This code is specifically used when the rhizotomy is performed on one or two vertebral segments, while a different code, CPT® 63190, is designated for procedures involving more than two segments.