Name of the Procedure:

Lumbar Orthosis, Sagittal Control
Common name(s): Lumbosacral orthosis, back brace.
Technical term: Lumbar Orthosis (HCPCS code L0627).

Summary

A lumbar orthosis is a type of back brace designed to support the spine from the L-1 vertebra to below the L-5 vertebra. It features rigid panels in the front and back, and often includes straps and closures. The brace helps to reduce the load on the intervertebral discs by creating intracavitary pressure.

Purpose

Conditions Addressed:

• Lower back pain
• Post-surgical recovery
• Herniated disc
• Spinal instability

Goals/Outcomes:

• Reduce pain and discomfort
• Stabilize the lumbar spine
• Aid in post-surgical healing
• Decrease load on intervertebral discs

Indications

• Chronic lower back pain
• Lumbar muscle weakness
• Post-operative immobilization
• Degenerative disc disease

Patient Criteria:

• Patients requiring stabilization after surgery
• Individuals with severe lower back pain unresponsive to other treatments
• Suitable for patients needing additional spinal support during recovery

Preparation

• No specific fasting or medication adjustments required.
• A thorough patient assessment and imaging (like X-rays or MRIs) might be done to determine the necessity and customization of the orthosis.

Procedure Description

1. Assessment: Healthcare provider evaluates the patient’s lumbar spine.
2. Fitting: The brace is properly fitted to the patient's body. This may involve adjustments to ensure a snug fit.
3. Instruction: The patient is taught how to put on, take off, and adjust the orthosis.
4. Wearing Schedule: Guidelines on when and how long to wear the brace are provided.

Tools/Equipment:

• Lumbar orthosis with rigid panels and straps
• Padding, if needed for comfort

Anesthesia:

Not applicable

Duration

Fitting and instruction typically take about 30-45 minutes.

Setting

• Outpatient clinic
• Orthotics and prosthetics office

Personnel

• Orthotist or prosthetist
• Physician (usually to prescribe and oversee)

Risks and Complications

Common Risks:

• Skin irritation or pressure sores
• Discomfort or improper fit

Rare Risks:

• Allergic reaction to materials used

Management:

• Regular monitoring and adjustments
• Use of padding to reduce irritation

Benefits

• Immediate reduction in pain and discomfort
• Improved posture and spinal stability
• Enhanced mobility and function

Recovery

• Follow instructions on the duration of use
• Monitor for skin irritation or discomfort
• Follow-up appointments for adjustments

Expected Recovery Time:

Individualized to the patient's condition and response, generally within a few weeks to months.

Alternatives

Other Options:

• Physical therapy
• Medications
• Alternative orthoses

Pros/Cons:

• Physical therapy and medications may take longer to show results but are less invasive.
• Other orthoses may not offer the same level of support and control.

Patient Experience

During Procedure:

• Minimal to no discomfort during fitting

After Procedure:

• May feel some restriction in movement initially
• Minimal pain with proper use

Pain Management:

• Adjustments can be made for comfort
• Skin care to avoid irritation