In spinal surgery, instrumentation refers to any hardware implanted into the spine to provide stability, correction, or fixation. It is used to immobilize spinal segments, maintain alignment, or support fusion.
Common Types of Spinal Instrumentation
1. Pedicle Screws
- Placed through the pedicle into the vertebral body
- Provide the primary anchor point
- Used in almost all thoracolumbar fusions
2. Rods
- Long metal rods connecting pedicle screws
- Allow correction of deformity and stabilization
3. Plates
- Anterior cervical plates most common
- Secured with screws to maintain alignment after fusion
4. Interbody Devices (Cages)
- Inserted into the disc space
- Restore disc height
- Promote fusion with bone graft
5. Hooks
- Used in scoliosis or deformity surgery
- Anchor at lamina or transverse process
6. Wires / Cables
- Sublaminar wires or titanium cables
- Used when screw purchase is poor
7. Crosslinks
- Connect left and right rod to increase torsional stability
Coding Note (If You Need It for CPT Documentation)
Instrumentation is coded separately from the fusion procedure, usually using:
- 22840–22847 for posterior segmental/nonsegmental instrumentation
- 22853–22859 for interbody devices
- 22848 for crosslink placement
- +22899 for unlisted situations
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