Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational stre...
HCPCS code
Name of the Procedure:
Thoracolumbosacral orthosis (TLSO), triplanar control, rigid posterior frame and flexible anterior apron, extended to scapula (HCPCS Code L0470)
Summary
The Thoracolumbosacral Orthosis (TLSO) is a spinal brace designed to stabilize the spine from the sacrococcygeal junction (lower back) to the scapula (upper back). It features a rigid frame at the back, complemented by a soft, adjustable front apron, padded straps, and closures.
Purpose
The TLSO helps manage and treat spinal conditions that require immobilization, such as spinal fractures, post-operative recovery, or severe spinal deformities. The primary goal is to maintain spinal alignment, limit movement, and reduce pain, thereby promoting healing or stabilizing the spine.
Indications
- Acute spinal fractures or injuries
- Post-operative stabilization following spinal surgery
- Degenerative spine conditions
- Severe scoliosis or kyphosis
- Chronic back pain requiring immobilization
Preparation
- Consultation with a healthcare provider to determine the need for a TLSO.
- X-rays or MRIs may be required to assess the spine and fit the brace appropriately.
- Fitting appointments to tailor the brace to the patient's body.
Procedure Description
- Fitting Session: The patient visits a specialist where measurements are taken.
- Custom Adjustment: The TLSO is adjusted based on the patient's anatomy.
- Application: The patient will put on the brace, ensuring the rigid posterior frame aligns with the spine and the flexible anterior apron wraps around the torso securely.
- Strapping and Padding: The brace is fastened using straps and closures, with additional padding for comfort. Adjustments can be made for a snug but comfortable fit.
Duration
Fitting and instruction sessions typically last 1-2 hours. The duration the brace is worn varies by condition but often spans weeks to months.
Setting
The fitting is generally performed in an orthopedic or prosthetic clinic. Application and adjustments can also be conducted in outpatient settings.
Personnel
- Orthotists
- Physical therapists
- Physicians (typically orthopedic surgeons)
- Nurses (for initial application and instruction)
Risks and Complications
- Skin irritation or pressure sores
- Muscle atrophy due to prolonged immobilization
- Discomfort or difficulty wearing the brace
- Possible improper fit requiring adjustments
Benefits
- Stabilizes and supports the spine
- Reduces pain and discomfort
- Promotes healing of spinal fractures or post-surgery recovery
- Helps correct or manage spinal deformities
Recovery
- Wear the brace as prescribed, typically for several hours a day.
- Follow-up appointments for adjustments and progress checks.
- Physical therapy may be recommended to strengthen spinal muscles.
- Patients may need time to adapt to wearing the brace.
Alternatives
- Other types of spinal braces or supports
- Physical therapy and exercise programs
- Pain management through medication or injections
- Surgical interventions if conservative measures fail
Patient Experience
Patients might initially experience discomfort as they get used to the brace. Pain management strategies include adjusting the fit, using additional padding, and taking prescribed medication if necessary. Over time, most patients find the brace becomes more tolerable and beneficial in managing their condition. Regular follow-ups and adjustments will ensure the TLSO fits properly and functions effectively.