Name of the Procedure:

• Common Name: Triplanar TLSO (Thoracolumbosacral Orthosis)
• Medical Term: Thoracolumbosacral Orthosis, Triplanar Control, Modular Segmented Spinal System (HCPCS Code: L0464)

Summary

The triplanar TLSO is a type of back brace used to support and stabilize the spine. It consists of four rigid plastic shells and is designed to cover the back from the lower spine up to just below the shoulder blades, and the front from the pelvic area up to the chest. The brace also includes a soft liner for added comfort and skin protection.

Purpose

The triplanar TLSO is used to treat various medical conditions affecting the spine, such as fractures, degenerative disc disease, scoliosis, or post-operative recovery. The main goals are to provide spinal support, prevent further injury, and promote proper spinal alignment.

Indications

The brace is indicated for patients with:

• Spinal fractures
• Post-operative spinal stabilization needs
• Severe degenerative disc disease
• Scoliosis requiring non-surgical treatment
• Other conditions needing external spinal support and immobilization

Preparation

No specific fasting or medication adjustment is typically required for fitting the brace. A diagnostic assessment, such as an X-ray or MRI, may be needed to determine the precise condition of the spine and to custom-fit the brace.

Procedure Description

1. Assessment: The healthcare provider conducts a thorough assessment and imaging to determine the spinal condition.
2. Measurement and Fitting: Measurements are taken of the patient's torso to ensure a proper fit.
3. Customization: The modular segmented spinal system is adjusted to fit the patient's body dimensions. The four rigid plastic shells are assembled and fitted accordingly.
4. Fitting: The soft liner is placed inside the brace for comfort, and the brace is secured around the patient's torso.
5. Adjustment and Instruction: The brace is adjusted for a snug fit, ensuring it effectively supports the spine. The patient is then instructed on how to wear, remove, and care for the brace.

Duration

The fitting process for the brace typically takes about 1-2 hours.

Setting

The procedure is generally performed in an outpatient clinic or specialized orthopedic facility.

Personnel

• Orthotist (specialist who designs and fits orthopedic braces)
• Nurse
• Physical Therapist (optional, for instructional support)

Risks and Complications

• Common Risks: Skin irritation or pressure sores from prolonged use.
• Rare Risks: Discomfort that may require further adjustment.
• Management typically involves addressing fit issues and protective measures for skin health.

Benefits

• Provides stabilization and support to the spine.
• Helps alleviate pain and prevent further injury.
• Aids in post-surgical recovery. Benefits are usually realized within a few weeks of consistent usage.

Recovery

• Post-procedure Care: Regular skin checks to prevent irritation, follow-up appointments for adjustments.
• Recovery Time: Varies depending on the underlying condition, but improvement in symptoms is often noted within weeks.
• Restrictions: Limited physical activity as recommended, adherence to wearing schedule as prescribed.

Alternatives

• Other Treatment Options: Non-rigid back braces, physical therapy, surgical interventions.
• Comparison: Surgical interventions may offer a more permanent solution but come with higher risks and longer recovery times. Non-rigid braces and physical therapy are less supportive but might be more comfortable for some patients.

Patient Experience

• During Fitting: Minimal discomfort during the fitting and adjustment process.
• Post-Fitting: Mild to moderate discomfort initially as the body adjusts to the brace, managed with over-the-counter pain relief if necessary.
• Comfort Measures: Soft liners and regular adjustments to ensure a snug yet comfortable fit.