CPT® Code 0612T

1. Indications

The procedure is indicated for the assessment of discogenic pain, which may arise from various conditions affecting the intervertebral discs in the cervical, thoracic, or lumbar regions. The following conditions may warrant the use of magnetic resonance spectroscopy:

• Disc Degeneration The presence of degenerative changes in the intervertebral discs that may contribute to pain.
• Herniated Discs Evaluation of discs that have herniated and may be causing nerve compression or pain.
• Discitis Inflammation of the disc space that can lead to pain and discomfort.
• Chronic Back Pain Assessment of chronic pain that may be linked to disc pathology.

2. Procedure

The procedure involves several key steps to ensure accurate determination and localization of discogenic pain through magnetic resonance spectroscopy:

• Step 1: Data Acquisition The initial step involves acquiring MRS data from the intervertebral discs using a magnetic resonance imaging (MRI) scanner. This data is collected in a manner that captures the biochemical composition of the discs.
• Step 2: Post-Processing After data acquisition, the MRS data undergoes a series of post-processing steps using specialized software. This includes optimal channel selection to enhance signal quality and phase error correction to rectify any discrepancies in the data.
• Step 3: Frame Editing The software performs frame editing to retain only high-quality frames, which is crucial for coherent averaging of spectra. This step ensures that the analysis focuses on the most reliable data, thereby improving the overall signal-to-noise ratio (SNR).
• Step 4: Baseline Correction and Artifact Filtering Baseline correction is applied to eliminate any unwanted noise from the spectral data, while artifact filtering removes any anomalies that could skew the results.
• Step 5: Quantification of Biomarkers The processed data is then analyzed to quantify various metabolites or biomarkers present in the discs. This quantification is expressed as peak values or ratios, which reflect the relative chemical differences between the discs.
• Step 6: Interpretation and Reporting Finally, the results of the MRS analysis are interpreted, and a comprehensive report is generated. This report includes the calculated total MRS score for each disc, which aids in diagnosing the source of discogenic pain.

3. Post-Procedure

Post-procedure care involves reviewing the interpretation and report generated from the MRS analysis. Healthcare professionals will assess the findings to determine the appropriate course of action based on the identified biomarkers and their implications for disc health. Patients may be advised on further diagnostic steps or treatment options depending on the results. Continuous monitoring and follow-up may be necessary to evaluate the effectiveness of any interventions initiated as a result of the MRS findings.