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Resection Lower Spine Bursa and Ligament to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | M Bursae and Ligaments |
| Operation | T Resection |
| Body Part | D Lower Spine Bursa and Ligament |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection procedures in this family involve cutting out an entire bursa or ligament without replacing it, typically because the structure has become a source of chronic pain, inflammation, or dysfunction that outweighs its remaining usefulness. A classic example is bursectomy for chronic olecranon or prepatellar bursitis that has failed conservative treatment, where the inflamed bursal sac is excised in its entirety rather than drained or repaired.
Surgeons pursue full resection when a bursa is persistently infected, calcified, or thickened, or when a ligament is so degenerated or contributing to impingement that removing it altogether is more beneficial than attempting repair. Unlike partial excisions performed to biopsy or debride tissue, resection removes the whole named structure. Patients typically recover well because bursae and many accessory ligaments are not essential to joint function once inflammation is resolved.
Anatomy & Axis Detail
Lower Spine Bursa and Ligament
The lower spine bursa and ligament category includes ligaments of the lumbar and sacral spine, such as the ligamentum flavum, interspinous, and supraspinous ligaments, which are frequently implicated in lumbar spinal stenosis. Resection here is most often performed as part of decompressive surgery, where a thickened or hypertrophied ligamentum flavum compresses the cauda equina or lumbar nerve roots and must be removed to relieve symptoms such as neurogenic claudication or radiculopathy. Because these ligaments contribute to segmental spinal stability, their removal is typically limited to the diseased portion causing compression rather than complete excision across multiple levels, and it is often combined with laminectomy or laminotomy in the same operative session. Documentation should specify the vertebral level and the extent of ligament removed.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
Coding & Documentation
A coder selects Resection when the documentation confirms complete removal of an entire bursa or ligament, not just a portion, and no replacement or graft material is used. Look for terms such as "bursectomy," "complete excision," or "ligament removed in its entirety." A common error is applying Resection when only part of the structure was taken, which should instead be coded as Excision, a distinct root operation reserved for partial removal. Coders also need to verify that removal was not a preliminary step to a Replacement procedure performed in the same operative episode, which would require separate coding.