CPT® Code 63200

The procedure described by CPT® Code 63200 refers to a laminectomy performed specifically to release a tethered spinal cord in the lumbar region. The conus medullaris, which is the terminal part of the spinal cord, typically moves freely within the cerebrospinal fluid. However, in cases of a tethered spinal cord, this mobility is compromised due to abnormal attachments to the surrounding tissues of the spinal canal. This condition is often congenital, frequently associated with conditions such as spina bifida and myelomeningocele, but it can also arise from traumatic injuries to the spinal cord. The tethering effect leads to stretching of the spinal cord during physical movement and as the individual grows, which can result in various neurological symptoms. These symptoms may include muscle weakness, sensory disturbances, and loss of bladder and bowel control, as well as orthopedic deformities. The surgical procedure involves making an incision over the affected lumbar vertebrae, extending down to the spinous processes, and carefully retracting the muscles to access the lamina and facet joint. A bone drill is utilized to remove the necessary bony structures to expose the tethered spinal cord. The dura mater, which encases the spinal cord, is then incised, allowing for the careful dissection and mobilization of the spinal cord from any surrounding scar tissue or fat, often with the assistance of an operating microscope. Once the spinal cord is fully released, the protective meninges are sutured closed or a dural patch graft may be applied to ensure proper healing and protection of the spinal cord.