Please suggest CPT codes:
1. Facet fusion TruFUSE L5-S1 bilaterally.
2. Forminotomy L4-L5 on left posterior fusion at L4-L5 with Aspen device and bone graft.
3. Reduction of spondylosis L4-5
Patient positioned prone, back was prepped and draped . Percu. K wire was placed in facet L5-S1 after localizing the facet on AP and lat & oblique views. This was followed by dilatation of facet insertion of cannula. Then drilling the facet joints on 2 sides was done and insertion of bone dowel. Once this was completed, both wounds were thoroughly washed and closed with interrupted sutures and couple of Monocryl to the skin.
A midline incision was made between the spinous process at L4-5 and L5-S1. Sharp dissection was carried down to skin and subcu tissues. Paravertebral dissection was carried down to expose lamina of L4 and L5 with a shaver and currette. Ligamentum flavum was lifeted on left side off the inferior surface and dissection carried down to interlaminar space.
Foraminotomy was performed, nerve hook was passed to confirm. This was followed by insertion of a dilating device between the interspinous process L4 & L5 and the area was decorticated. This was followed by insertion after dilatation of interspinous for spondylosis at L4-5 grade 1 as well as locking it in place between the spinous process with bone graft inserted in circular part of Aspen device.
Once left in place, the facets & interforamninal spaces were wide opened and spondylosis at L5 was also reduced. Once this was accomplished, washout of wounds was performed and wound closed.
1. Facet fusion TruFUSE L5-S1 bilaterally.
2. Forminotomy L4-L5 on left posterior fusion at L4-L5 with Aspen device and bone graft.
3. Reduction of spondylosis L4-5
Patient positioned prone, back was prepped and draped . Percu. K wire was placed in facet L5-S1 after localizing the facet on AP and lat & oblique views. This was followed by dilatation of facet insertion of cannula. Then drilling the facet joints on 2 sides was done and insertion of bone dowel. Once this was completed, both wounds were thoroughly washed and closed with interrupted sutures and couple of Monocryl to the skin.
A midline incision was made between the spinous process at L4-5 and L5-S1. Sharp dissection was carried down to skin and subcu tissues. Paravertebral dissection was carried down to expose lamina of L4 and L5 with a shaver and currette. Ligamentum flavum was lifeted on left side off the inferior surface and dissection carried down to interlaminar space.
Foraminotomy was performed, nerve hook was passed to confirm. This was followed by insertion of a dilating device between the interspinous process L4 & L5 and the area was decorticated. This was followed by insertion after dilatation of interspinous for spondylosis at L4-5 grade 1 as well as locking it in place between the spinous process with bone graft inserted in circular part of Aspen device.
Once left in place, the facets & interforamninal spaces were wide opened and spondylosis at L5 was also reduced. Once this was accomplished, washout of wounds was performed and wound closed.
