I am needing some assistance on a code choice for the corepctomy that my physician performed. He did this approach from a transpendicular approach for L1-2 disc space, patient has discitis, osteomyelitis with an epidural abscess.
procedures performed:
L1-2 decompression and laminectomy
Subtotal vertebrectomy and diskectomy L2 and L1-2 disc space
evacuation of epidural abscess at L1-2
Posterior instrumentation and fusion T11-L4
Interbody cage at L1-2
here is the procedure performed below:
We started with a 15cm incision over the back, dissecting down to the level of the T11 through L4 spinous processes. We exposed the transverse processes and facet joints of each level with careful hemostasis. We then identified our start points for our screws and inserted pedicle screws using a posterolateral techinque with XR assistance. Rods were measured and placed with set screws. We then began our L1-2 decompression and fusion with the assistance of a burr and kerosin rongers. The dura was adequatley decompressed without signs of a dural leak. We then began our posterolateral transpedicular access to the L1-2 disc space. The left pedicle was removed in its entirety and we inserted a curette to clean out the disc space and vertebral body. The epidural abscess was evacuated and cultures were taken. Antibiotics were then provided. We measued and cut a cage out to size. The cage was inserted into the L1-2 disc space with excellent purchase. The rods and screws were final tightened and final xrays were taken and saved.
thank you all for your assistance!
procedures performed:
L1-2 decompression and laminectomy
Subtotal vertebrectomy and diskectomy L2 and L1-2 disc space
evacuation of epidural abscess at L1-2
Posterior instrumentation and fusion T11-L4
Interbody cage at L1-2
here is the procedure performed below:
We started with a 15cm incision over the back, dissecting down to the level of the T11 through L4 spinous processes. We exposed the transverse processes and facet joints of each level with careful hemostasis. We then identified our start points for our screws and inserted pedicle screws using a posterolateral techinque with XR assistance. Rods were measured and placed with set screws. We then began our L1-2 decompression and fusion with the assistance of a burr and kerosin rongers. The dura was adequatley decompressed without signs of a dural leak. We then began our posterolateral transpedicular access to the L1-2 disc space. The left pedicle was removed in its entirety and we inserted a curette to clean out the disc space and vertebral body. The epidural abscess was evacuated and cultures were taken. Antibiotics were then provided. We measued and cut a cage out to size. The cage was inserted into the L1-2 disc space with excellent purchase. The rods and screws were final tightened and final xrays were taken and saved.
thank you all for your assistance!