Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure t...
HCPCS code
Lumbar-Sacral Orthosis (L0637)
Name of the Procedure:
Common Names: Lumbar brace, back brace, spinal brace.
Technical Terms: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels (HCPCS L0637).
Summary
A lumbar-sacral orthosis is a type of back brace designed to support and stabilize the lower spine, specifically from the sacrococcygeal junction to the T-9 vertebra. It features rigid panels and frames that control the movement of the spine in multiple directions, helping to reduce pain and promote healing.
Purpose
Medical Conditions Addressed:
- Lower back pain
- Spinal instability
- Post-surgical support
- Conditions such as spondylolisthesis, spinal stenosis, or lumbar fractures
Goals:
- Provide spinal stability
- Restrict unnecessary movement
- Reduce pain and discomfort
- Support healing and recovery
Indications
Symptoms or Conditions:
- Chronic lower back pain
- Acute injuries to the lumbar-sacral spine
- Post-operative patients recovering from lumbar spine surgery
- Spinal deformities requiring support
Patient Criteria:
- Those needing immobilization and stabilization of the lumbar region
- Patients with specific spinal conditions or following lower back surgery
Preparation
Pre-Procedure Instructions:
- Review patient’s medical history and symptoms
- Physical examination to assess proper fit
- No specific fasting or medication adjustments required
Diagnostic Tests:
- Imaging studies such as X-rays or MRIs to determine the extent of the spinal condition
Procedure Description
- Assessment: The patient is evaluated to determine the correct size and type of orthosis needed.
- Fitting: The brace is custom-fitted to the patient, ensuring the rigid frames align with anatomical landmarks from the sacrococcygeal junction to T-9 vertebra.
- Adjustment: Straps and panels are adjusted to provide adequate support and immobilization without causing discomfort.
- Instruction: The patient is educated on how to wear and adjust the brace properly, as well as how to care for it.
Tools and Equipment: Rigid brace with anterior, posterior, and lateral panels; adjustable straps.
Anesthesia: Not applicable.
Duration
The fitting and adjustment process typically takes about 30-60 minutes.
Setting
The procedure is typically performed in a medical office, outpatient clinic, or rehabilitation center.
Personnel
- Orthopedic specialist or spine surgeon
- Orthotist
- Medical assistants or nurses for support
Risks and Complications
Common Risks:
- Skin irritation or pressure sores
- Discomfort or pain if not fitted correctly
Rare Risks:
- Nerve compression if the brace is too tight
- Reduced blood circulation
Management: Regular follow-ups to adjust the fit and monitor skin health.
Benefits
- Expected Benefits: Improved spinal stability, reduced pain, and enhanced healing following spinal injury or surgery.
- Timeline: Benefits can often be realized almost immediately but may improve over several weeks as healing progresses.
Recovery
Post-Procedure Care:
- Adhere to wearing schedule as recommended
- Perform skin checks daily
- Follow-up appointments for brace adjustments
Recovery Time:
- Varies by individual and condition; can range from a few weeks to several months
Restrictions:
- Avoid activities that could strain the back
- Gradually resume normal activities as advised by a healthcare provider
Alternatives
Other Treatment Options:
- Physiotherapy
- Pain management strategies (medication, injections)
- Other types of orthoses or braces with different designs
Pros and Cons:
- Physiotherapy can strengthen muscles but may not provide immediate support.
- Medications manage pain but do not stabilize the spine.
- Alternative braces might offer varying levels of support and comfort.
Patient Experience
During Procedure:
- Minimal discomfort; feeling of snugness as the brace is fitted and adjusted
After Procedure:
- Initial adjustment period to get used to wearing the brace
- Some may experience temporary discomfort until fully accustomed
Pain Management:
- Over-the-counter pain relief if necessary
- Regular skin checks to prevent irritation and sores
Comfort Measures:
- Properly padded undergarments and clothing to enhance comfort while wearing the brace.