Name of the Procedure:

Common Name: Sacroiliac Orthosis Technical Term: Sacroiliac Orthosis, Flexible, Pelvic-Sacral Support, Custom Fabricated (HCPCS Code: L0622)

Summary

A sacroiliac orthosis is a custom-fabricated brace designed to stabilize the sacroiliac (SI) joint by providing support and reducing motion in the pelvic-sacral region. This device typically includes various straps and closures that help secure it in place and may come with design features to accommodate a pendulous abdomen.

Purpose

The sacroiliac orthosis is used primarily to:

• Address conditions involving instability or dysfunction of the sacroiliac joint.
• Provide pelvic-sacral support to alleviate pain and discomfort.
• Reduce motion at the SI joint, improving overall function and mobility.
• Help in the rehabilitation process by stabilizing the pelvic area.

Indications

The sacroiliac orthosis is indicated for patients with:

• Sacroiliac joint instability or dysfunction.
• Lower back pain localized around the SI joint.
• Conditions such as sacroiliitis or post-traumatic sacroiliac injuries.
• Patients requiring additional support due to ligamentous laxity or hypermobility.

Preparation

To prepare for fitting a sacroiliac orthosis:

• There are typically no specific pre-procedure instructions like fasting.
• An assessment by a healthcare provider, including a possible physical examination and imaging tests (e.g., X-rays, MRI), to confirm the suitability of the orthosis.
• Measurements of the pelvic and abdominal region to ensure a custom fit.

Procedure Description

1. A healthcare provider assesses the patient's pelvic-sacral area and takes precise measurements.
2. Custom fabrication of the orthosis based on these measurements, which might take several days.
3. Once the orthosis is ready, the patient returns for fitting. The provider adjusts the straps and closures for optimal support and comfort.
4. Instructions are provided on how to wear, adjust, and care for the orthosis.

Typically, no anesthesia or sedation is required for this procedure.

Duration

The initial fitting session usually takes about 30 minutes to 1 hour.

Setting

The procedure is generally performed in an outpatient clinic or an orthotics and prosthetics office.

Personnel

• Orthotist (specialist in the design and fitting of orthoses)
• Physical Therapist (possibly involved for follow-up and assessment)
• Physician (for initial assessment and final approval)

Risks and Complications

• Skin irritation or pressure sores from improper fit.
• Discomfort due to tightness or inadequate adjustment.
• Potential for allergic reactions to materials used in the orthosis.
• Reduced mobility if not properly fitted.

Benefits

• Relief from pain and discomfort associated with SI joint issues.
• Improved stability in the pelvic-sacral region.
• Enhanced ability to perform daily activities with reduced pain.
• Potential long-term benefits in joint function with consistent use.

Patients may start noticing improvements within a few days to weeks of wearing the orthosis.

Recovery

• Follow the provider's recommendations on how often to wear the orthosis (often daily use for several hours).
• Regular cleaning and maintenance of the device as instructed.
• Attend follow-up appointments to adjust the fit as needed.
• Gradual resumption of activities with the support of the orthosis.

Alternatives

• Physical therapy focusing on strengthening and stabilizing exercises for the pelvic region.
• Medications like analgesics or anti-inflammatory drugs.
• Injections (e.g., corticosteroids) for inflammation and pain.
• Surgical options in severe cases where conservative treatments are ineffective.

Patient Experience

During the fitting:

• Minor discomfort when adjusting straps and closures.
• Potential feeling of tightness initially as the body adapts to the support.

Post-Fitting:

• Relief from symptoms as the orthosis stabilizes the joint.
• Some initial difficulty with movement adjustments.
• Regular check-ins with the provider for any discomfort or issues with the orthosis fit.
• Pain management with over-the-counter pain relievers if needed.

Overall, patients are likely to experience improved stability and symptom relief with proper use of the sacroiliac orthosis.