Overview of CPT Code 22361: Percutaneous vertebroplasty, unilateral

CPT Code 22361 refers to a minimally invasive procedure called percutaneous vertebroplasty, which is performed unilaterally to stabilize vertebral compression fractures. This procedure involves the injection of bone cement into the fractured vertebra to provide immediate pain relief and restore vertebral stability.

When CPT Code 22361 is Used?

Percutaneous vertebroplasty is indicated in specific clinical scenarios.

Patients with painful vertebral compression fractures due to osteoporosis.
Individuals with fractures resulting from trauma or malignancy.
Patients who have not responded to conservative treatments such as pain medication or physical therapy.

Symptoms Indicating This Procedure

Patients typically present with various symptoms that may warrant this procedure.

Severe back pain localized to the site of the fracture.
Pain that worsens with movement or standing.
Limited mobility and difficulty performing daily activities.
Neurological symptoms such as numbness or weakness in the legs.

Causes and Risk Factors

Understanding the causes and risk factors can help in identifying patients who may benefit from this procedure.

Osteoporosis leading to weakened bones.
Age-related bone density loss.
Trauma or injury to the spine.
Certain cancers that metastasize to the vertebrae.

Diagnostic Tests Before Procedure

Several diagnostic tests are essential to confirm the need for vertebroplasty.

X-rays to visualize the fracture.
MRI to assess the extent of the fracture and surrounding tissues.
CT scans for detailed imaging of the vertebrae.

Procedure Description

The procedure is performed under local anesthesia and sedation.

The patient is positioned comfortably, usually lying on their stomach.
A small incision is made in the skin over the affected vertebra.
A needle is inserted through the incision and guided into the fractured vertebra using imaging guidance.
Bone cement is injected into the vertebra to stabilize the fracture.
The needle is removed, and the incision is closed with a bandage.

Preparation for the Procedure

Proper preparation is crucial for a successful outcome.

Patients should inform their doctor about any medications they are taking.
Fasting may be required for a few hours before the procedure.
Arranging for transportation home post-procedure is recommended.

Recovery and Aftercare

Recovery typically involves a short hospital stay and follow-up care.

Patients may experience some soreness at the injection site.
Pain relief is often immediate, but full recovery may take several weeks.
Follow-up appointments are necessary to monitor healing and pain levels.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

Infection at the injection site.
Bleeding or hematoma formation.
Nerve damage leading to neurological symptoms.
Cement leakage into surrounding tissues.

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Post-Procedure Follow-Up

Follow-up care is essential to ensure proper healing.

Patients should have a follow-up appointment within a week after the procedure.
Additional imaging may be performed to assess the success of the procedure.
Regular check-ins with the healthcare provider to monitor pain and mobility.

Alternative Treatments

There are several non-surgical options available for managing vertebral fractures.

Physical therapy to strengthen back muscles.
Pain management with medications such as NSAIDs.
Bracing to support the spine during healing.
Vertebral augmentation techniques like kyphoplasty.

Home Care Tips

Patients can take several steps to aid their recovery at home.

Avoid heavy lifting and strenuous activities for a few weeks.
Use ice packs to reduce swelling and discomfort.
Engage in gentle stretching and mobility exercises as advised by a healthcare provider.