CPT® Code 72291

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1. Indications

The procedure associated with CPT® Code 72291 is indicated for the following conditions:

• Vertebral Compression Fractures - These fractures occur when the vertebrae become weakened, often due to osteoporosis or trauma, leading to a collapse of the vertebral body.
• Vertebral Body Collapse - This condition involves the loss of structural integrity of the vertebra, which can result in pain and functional impairment.
• Chronic Pain Relief - Patients experiencing persistent pain due to vertebral fractures or collapse may benefit from this procedure to restore stability and alleviate discomfort.
• Prevention of Further Fractures - By stabilizing the affected vertebra, the procedure aims to prevent additional fractures that may occur as a result of weakened bone structure.

2. Procedure

The procedure for CPT® Code 72291 involves several critical steps that ensure effective radiological supervision and interpretation during vertebroplasty or augmentation:

• Step 1: Patient Positioning - The patient is positioned appropriately to allow optimal access to the vertebral body requiring intervention. This positioning is crucial for effective fluoroscopic guidance.
• Step 2: Fluoroscopic Guidance Setup - Continuous fluoroscopic imaging is established to provide real-time visualization of the vertebral anatomy and the instruments used during the procedure.
• Step 3: Needle Insertion - A needle is carefully guided into the targeted vertebral body through the skin, utilizing fluoroscopic guidance to ensure accurate placement at the site of the defect.
• Step 4: Cavity Creation (if necessary) - If the vertebra is significantly collapsed, inflatable instruments may be inserted to create a cavity, restoring the normal height of the vertebral body before proceeding with cement injection.
• Step 5: Bone Cement Injection - Once the cavity is prepared, a mixture of bone cement and contrast medium is injected into the vertebral body. This step is monitored closely via fluoroscopy to confirm that the cement fills the intertrabecular bone marrow space adequately.
• Step 6: Needle Withdrawal - After the cement has been injected and its placement confirmed, the needle is withdrawn from the vertebral body.
• Step 7: Repeat Procedure (if necessary) - If additional vertebrae require treatment, the procedure may be repeated on the opposite side or on other affected vertebrae as indicated.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 72291, patients may be monitored for any immediate complications or adverse effects. It is essential to assess the patient's pain levels and overall stability. Follow-up imaging may be required to evaluate the success of the cement placement and the restoration of vertebral height. Patients are typically advised on post-procedure care, which may include activity restrictions and pain management strategies to facilitate recovery. A written report detailing the radiological supervision and interpretation of the procedure is provided by the physician, documenting the findings and any relevant observations made during the intervention.