Application of Risser jacket, localizer, body; only
CPT4 code
Name of the Procedure:
Application of Risser Jacket, Localizer, Body; Only (Common names: Risser jacket application, Body cast application)
Summary
The application of a Risser jacket involves encasing the torso in a specialized body cast. This cast is used primarily to immobilize the spine, ensuring stability and encouraging proper alignment during the healing process.
Purpose
This procedure addresses conditions that require spinal immobilization, such as scoliosis, spinal fractures, or post-operative stabilization. The main goals are to support the spine, reduce pain, prevent further injury, and promote healing by maintaining proper spinal alignment.
Indications
- Severe scoliosis
- Spinal fractures
- Post-operative stabilization following spinal surgery
- Conditions requiring immobilization of the spine for proper healing
Patient Criteria:
- Diagnosis of a condition requiring spinal immobilization
- Ability to tolerate a body cast
Preparation
- Patients may be instructed to fast for a few hours prior to the procedure.
- Appropriate imaging (e.g., x-rays, MRIs) will be reviewed.
- Patients should inform the medical team of any medications, allergies, or underlying medical conditions.
Procedure Description
- Positioning: The patient is positioned to allow access to the torso.
- Measurements: Exact body measurements are taken to ensure a proper fit.
- Casting: A layer of padding is applied to protect the skin, followed by the application of the casting material which hardens to form the body jacket.
- Fitting: The cast is shaped and molded to ensure proper support and comfort.
- Local Anesthesia: In some cases, local anesthesia may be used to minimize discomfort.
Tools and Equipment:
- Measuring tape
- Padding materials
- Casting materials (plaster or fiberglass)
- Scissors and shaping tools
Duration
The procedure typically takes 1 to 2 hours.
Setting
The application of a Risser jacket is usually performed in a hospital or an outpatient clinic.
Personnel
- Orthopedic surgeon or specialist
- Nurse or medical assistant
- Anesthesiologist (if local anesthesia is used)
Risks and Complications
- Skin irritation or pressure sores
- Cast discomfort
- Restricted breathing or mobility
- Rare complications: circulatory issues or deep vein thrombosis (DVT)
Benefits
- Stabilizes and aligns the spine, promoting healing
- Reduces pain and prevents further injury
- Improves functional outcomes
Expected Timeline for Benefits:
- Immediate stabilization and pain reduction
- Improved spinal alignment and healing over weeks to months
Recovery
- Follow-up appointments for cast adjustments and monitoring
- Instructions on maintaining skin hygiene and monitoring for signs of complications
- Limited physical activity to prevent damage to the cast
- Full recovery varies; strict compliance with medical advice is essential
Alternatives
- Bracing: A less restrictive option for milder conditions
- Surgical stabilization: Considered for severe cases where casting is insufficient
- Physical therapy: For non-immobilization treatment plans
Pros and Cons:
- Bracing: More mobility but less support
- Surgery: Permanent solution but with higher risks and longer recovery
- Physical Therapy: Non-invasive but may not provide immediate stabilization
Patient Experience
- During the procedure, there may be discomfort from the casting process.
- Post-procedure, patients may feel restricted in movement and unfamiliar with the cast.
- Pain management strategies and instructions on how to navigate daily activities with the cast will be provided.