Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervert...
HCPCS code
Name of the Procedure:
Lumbar-sacral orthosis (L0639)
Common names: Back brace, spinal orthosis
Technical term: Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s)
Summary
A lumbar-sacral orthosis is a type of back brace designed to support and stabilize the lower spine. It has rigid shells or panels that align the spine from the sacrococcygeal junction (the base of the spine) to the T-9 vertebra (mid back), and from the front of the pelvis up to the lower ribcage.
Purpose
The lumbar-sacral orthosis helps manage lower back pain, spinal instability, and post-surgical spinal healing. It aims to reduce the load on the intervertebral discs by producing intracavitary pressure, thereby alleviating pain and improving mobility.
Indications
- Chronic lower back pain
- Spinal instability or fractures
- Post-surgical stabilization (e.g., spinal fusion)
- Conditions such as scoliosis, spondylolisthesis, or degenerative disc disease
Preparation
- No fasting or sedation required.
- A physician may conduct a thorough physical examination and imaging studies (X-rays, MRI) to assess the spine.
Procedure Description
- Patient consultation: Measure and fit the brace.
- Application: The back brace is fitted with the posterior extending from the sacrococcygeal junction to the T-9 vertebra and the anterior extending from the symphysis pubis to the xiphoid process.
- Adjustment: Straps and panels are adjusted for a snug fit to ensure effective support and pressure.
- Instruction: Patient is educated on how to wear, remove, and care for the brace.
Duration
The fitting and adjustment process typically takes about 30 minutes.
Setting
The procedure is generally performed in an outpatient clinic or an orthopedic specialist's office.
Personnel
- Orthopedic specialist or physical therapist
- Medical assistant or technician (for measuring and fitting)
Risks and Complications
- Skin irritation or sores from prolonged use
- Muscle atrophy if used excessively without medical supervision
- Discomfort if not fitted properly
- Rarely, respiratory issues from overly tight fit
Benefits
- Pain relief and improved spinal stability
- Enhanced mobility and daily function
- Provides support to healing structures post-surgery
- Immediate effects with proper usage
Recovery
- Patients can generally resume regular activities with the brace.
- Follow-up appointments to adjust fit and monitor progress
- Regular skin checks for irritation
Alternatives
- Physical therapy and core strengthening exercises
- Pain medications or anti-inflammatory drugs
- Surgical options for severe cases
- Pros of alternatives: No device dependency, targeted therapies
- Cons of alternatives: May require a longer duration to see benefits, potential side effects of medications
Patient Experience
- Initial fitting might be slightly uncomfortable.
- Daily wear should be manageable and comfortable.
- Follow prescribed wear schedule to avoid dependency.
- Pain management strategies include positioning changes and possibly over-the-counter pain relief.