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At this juncture the endoscope was placed, and the disc space was investigated. Asignificant amount of inflamed (red) annular tissue was noticed. Extensive scar tissue was found to surrounding the L4 existing nerve in the superior foraminal notch. The decompression was made in the inferior foraman to expose posterior L4-5 margin with holmium laser and ellman radiofrequency. The L4-5 disc was entered with radiofrequency probe under direct vision and confirmed with AP and later view of fluoroscopy. Less than 5cc disc material was removed with manual grasper. The posterior part to annular tissue was treated with ellman radiofrequency. Holmium laser was used to smooth and shrink the posterior annular disc material. The scar tissue surrounding the L4 exiting nerve root was removed with the holmium laser. Once the decompression and annuloplasty were satisfactory, endoscopy was carefully once again performed in the neurofoman at the left L4-5.
63056 or does is it unlisted spinal procedure, what do you think?
63056 or does is it unlisted spinal procedure, what do you think?