Application of body cast, shoulder to hips
CPT4 code
Name of the Procedure:
Application of Body Cast, Shoulder to Hips
(Also known as: Thoracolumbosacral Orthosis (TLSO) application)
Summary
This procedure involves the application of a body cast that extends from the shoulders to the hips to immobilize the spine and torso. The cast is made of rigid materials like plaster or fiberglass and is used to support and protect the body after a serious injury or surgery.
Purpose
The body cast is used to treat spinal fractures, severe scoliosis, or after spinal surgery to ensure proper alignment and healing. The goal is to stabilize the spine and prevent further injury while promoting recovery.
Indications
- Spinal fractures
- Severe scoliosis
- Postoperative spinal stabilization
- Certain severe muscle and ligament injuries in the back
Preparation
- Patients may be asked to fast for several hours if sedation is needed.
- Diagnostic tests such as X-rays or MRIs may be required to assess the spine and the extent of injury.
- Any medications should be discussed with the healthcare provider to determine if adjustments are needed.
Procedure Description
- The patient is positioned appropriately, usually lying down or standing.
- The skin is protected with a thin layer of padding.
- Preliminary measurements are taken to ensure a correct fit.
- The casting material (plaster or fiberglass) is soaked in water to activate it.
- The material is then wrapped around the torso, from shoulders to hips, and molded to fit the body contours.
- The cast is allowed to harden and dry fully, which can take about 10-15 minutes.
- Final adjustments are made to ensure comfort and proper immobilization.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital, outpatient clinic, or surgical center.
Personnel
- Orthopedic surgeon or specialist
- Nurse or medical assistant
- Radiologic technologist for initial imaging
Risks and Complications
- Skin irritation or breakdown under the cast
- Pressure sores
- Cast may become too tight or too loose
- Possible complications with breathing if the cast is improperly fitted
Benefits
- Stabilizes the spine and promotes healing
- Prevents further injury or complications
- May reduce pain by immobilizing the affected area
Recovery
- Patients should keep the cast dry to prevent skin complications.
- Regular follow-up appointments are needed to assess the fit and condition of the cast.
- Restricted movement and activity for the duration of the cast wear, usually 6 to 12 weeks.
Alternatives
- Bracing or support garments (less rigid but also less supportive)
- Physical therapy and pain management for less severe injuries
- Surgical intervention if deemed necessary
Patient Experience
- Initial discomfort or tightness as the cast dries.
- Limited mobility and possible need for assistance with daily activities.
- Pain management strategies may include prescribed medications or over-the-counter pain relievers.
- Instructions on how to monitor for complications and when to seek medical advice are provided.