Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to s...
HCPCS code
Name of the Procedure:
Torso Orthosis, Triplanar Control, Custom Fabricated (L0480)
Summary
A Triplanar Control Thoracolumbosacral Orthosis (TLso), constructed from a one-piece rigid plastic shell with multiple straps and closures. This device is designed to provide support and stabilization to the spine, extending from the sacrococcygeal junction to just below the scapular spine at the back, and from the symphysis pubis to the sternal notch at the front.
Purpose
The TLso aims to stabilize and support the thoracic and lumbar spine in multiple planes, used primarily for spinal conditions or injuries that require significant immobilization and support. The goal is to restrict motion, reduce pain, and promote healing or correction.
Indications
- Spinal fractures
- Post-operative recovery from spinal surgery
- Severe scoliosis or kyphosis
- Degenerative spine conditions
- Chronic spine instability
Preparation
- Patients may be required to wear lightweight, breathable clothing or a liner underneath the brace to prevent skin irritation.
- Specific instructions on the correct way to apply and adjust the orthosis will be provided.
- Routine assessments may include imaging studies like X-rays or MRIs to guide customization.
Procedure Description
- Measurement and Customization: Initial patient measurements and molding of the rigid plastic shell to fit the patient's body contours.
- Fabrication: The custom orthosis is crafted based on the measurements and mold.
- Fitting: The orthosis is fitted, ensuring proper alignment and comfort.
Instruction: Detailed instructions are given on how to wear, adjust, and maintain the orthosis.
Tools include measurement tape, molds for shaping the plastic, scissors for trimming, and multiple straps with closures for securing the device. No anesthesia or sedation is required as the procedure is external and non-invasive.
Duration
The fitting and customization process usually takes a few hours over multiple visits. Each session might last between 30 minutes to an hour.
Setting
The procedure is commonly performed in an orthopedic clinic, a rehabilitation center, or a hospital's outpatient orthotics department.
Personnel
- Orthotist
- Physical Therapist
- Physicians (especially in collaborative cases)
Risks and Complications
- Skin irritation or pressure sores
- Discomfort from prolonged use
- Improper fitting leading to inadequate support
- Need for adjustments over time as the patient’s condition changes
Benefits
- Immediate spinal support and pain reduction
- Prevention of further spinal injury or deformity
- Enhanced post-operative recovery and healing
- Improved mobility and quality of life
Recovery
- Wear the orthosis as directed, often for several weeks to months.
- Perform gentle exercises or rehabilitation as recommended.
- Follow up with healthcare providers for adjustments and monitoring.
- Alert your healthcare provider if there are signs of skin irritation or increased pain.
Alternatives
- Non-rigid braces or corsets, which provide less support
- Physical therapy alone for mild cases
- Surgical options for severe or unresponsive conditions
- Medication for pain management without bracing
Patient Experience
Patients may experience initial discomfort as they adapt to wearing the rigid orthosis. Over time, most patients report reduced spine pain and better mobility. Pain management strategies might include wearing a soft undershirt, frequent skin checks, and graded exercises to maintain muscle strength.