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Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, m...

HCPCS code

Name of the Procedure:

Common Name: Lumbar-Sacral Orthosis (LSO)
Medical Term: L0631 Lumbar-Sacral Orthosis, sagittal control, with rigid anterior and posterior panels

Summary

A Lumbar-Sacral Orthosis (LSO) is a type of back brace designed to provide support and stability to the lower spine. It is rigid, with panels in both the front and back, and it extends from the sacrococcygeal junction (tailbone) to the T-9 vertebra (mid-back). The brace helps reduce the load on intervertebral discs by creating internal pressure, which alleviates pain and promotes healing.

Purpose

LSO is primarily used to address lower back pain, spinal instability, and to aid in post-operative recovery for spinal surgeries. The goal is to reduce spinal load, stabilize the lumbar region, and allow for healing by restricting unnecessary movements, all while alleviating pain.

Indications

  • Chronic lower back pain
  • Lumbar spine instability
  • Degenerative disc disease
  • Spondylolisthesis
  • After lumbar spine surgery
  • Compression fractures

Preparation

  • No specific fasting or dietary adjustments needed.
  • Ensure any underlying conditions or compatibility with other therapies are discussed with a healthcare provider.
  • Measurement and fitting session to ensure the orthosis fits properly.

Procedure Description

  1. Fitting: The patient undergoes a fitting session to ensure the orthosis fits well.
  2. Wearing the Orthosis: The patient dons the LSO, ensuring it is snug and well-aligned with the sacrococcygeal junction and T-9 vertebra.
  3. Adjustment: Straps and closures are adjusted to optimize comfort and effectiveness.
  4. Daily Use: The orthosis is worn during the day and removed at night, as per the doctor's recommendations.

No anesthesia or sedation is required.

Duration

  • Initial fitting: approximately 30 minutes to 1 hour.
  • Daily wear: as prescribed by the healthcare provider, typically throughout waking hours.

Setting

  • Outpatient clinic or orthopedic specialist office for initial fitting.

Personnel

  • Orthopedic specialist or therapist for fitting and instruction.
  • Primary care provider for continued monitoring.

Risks and Complications

  • Skin irritation or sores from the brace
  • Muscle atrophy from extended use
  • Discomfort or improper fit leading to ineffectiveness
  • Rarely, nerve compression if not fitted or adjusted properly

Benefits

  • Reduced pain and discomfort in the lower back.
  • Enhanced stability and support for the lumbar region.
  • Facilitates healing post-surgery or from injury.
  • Improved mobility and function over time.

Recovery

  • Immediate pain relief and support upon wearing the device.
  • Continual improvement in spinal stability and pain levels.
  • Regular follow-ups to adjust the orthosis as necessary.
  • Gradual reduction in orthosis use as strength and stability return.

Alternatives

  • Physical therapy and exercise.
  • Non-steroidal anti-inflammatory drugs (NSAIDs).
  • Other types of back braces or supports.
  • Surgical interventions in severe cases.

Patient Experience

  • Initially, there might be some discomfort as the patient adjusts to the brace.
  • Skin checks are necessary to avoid irritation.
  • Pain management strategies and regular adjustments will be discussed to ensure optimal comfort and effectiveness.

Medical Policies and Guidelines for Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, m...

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