CPT® Code 63190

Rhizotomy is a surgical procedure aimed at alleviating spasticity, particularly in patients who have not found relief through oral medications or less invasive treatments. This condition often affects individuals with severe lower extremity spasticity, such as those diagnosed with cerebral palsy. The procedure involves a laminectomy, which is the surgical removal of a portion of the lamina, a bony structure that covers the spinal canal. By performing a laminectomy, the surgeon gains access to the spinal cord and the associated nerve roots. During the procedure, the surgeon carefully incises the skin over the spine in the targeted area, extending the incision down to the spinous processes. Muscle tissue is then retracted to expose the lamina and facet joint. A specialized bone drill is utilized to remove part or all of the lamina, allowing for the exposure of the spinal cord and nerve roots. To identify the specific motor nerve rootlets responsible for the spasticity, electrical stimulation is applied selectively. Once identified, these nerve rootlets are cut to reduce the spasticity. This procedure is indicated when spasticity is severe and has not responded to other treatment modalities. It is important to note that CPT® Code 63190 is specifically used when the rhizotomy is performed on more than two vertebral segments, distinguishing it from similar procedures that may involve fewer segments.