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 (LSO), Sagittal-Coronal Control
Common names: Lumbar brace, Back brace, LSO
Technical/Medical term: Lumbar-Sacral Orthosis, sagittal-coronal control, rigid shell(s)/panel(s) (HCPCS L0640)
Summary
The Lumbar-Sacral Orthosis (LSO) is a specialized brace designed to support the lumbar and sacral regions of the spine. It features rigid shells or panels to stabilize the lower and mid-back, extending from the sacrococcygeal junction (tailbone area) to the T-9 vertebra (mid-spine) posteriorly, and from the symphysis pubis (lower front of the pelvis) to the xiphoid process (lower end of the sternum) anteriorly.
Purpose
The LSO is used to manage and alleviate lower back pain and instability. It helps to:
- Reduce the load on the intervertebral discs and spine.
- Promote proper spinal alignment.
- Improve functional mobility for daily activities.
- Prevent further injury or deterioration of the spine.
Indications
- Severe lower back pain or instability.
- Post-surgical stabilization after spinal surgery.
- Fractures or trauma to the lumbar or sacral regions.
- Degenerative disc disease, spondylolisthesis, or scoliosis.
- Patients who require restricted motion in the sagittal and coronal planes.
Preparation
- No special fasting is required.
- Patients should inform their healthcare provider of any medications they are taking.
- A physical examination and if applicable, imaging tests like X-rays or MRIs might be conducted to determine the need for the orthosis and the appropriate fit.
Procedure Description
- Assessment and Measurement: The healthcare provider assesses the patient's spine and measures for the customized fit of the LSO.
- Fitting the Orthosis: The brace is fitted around the patient's torso, ensuring it covers the necessary anatomical landmarks from the sacrococcygeal junction to T-9 posteriorly and from the symphysis pubis to the xiphoid process anteriorly.
- Adjustment: Straps and fasteners are adjusted to ensure the brace is snug but not too tight, preventing discomfort and ensuring effectiveness.
- Instruction: The patient receives instructions on how to wear, remove, and care for the orthosis.
Duration
The fitting procedure typically takes about 30-60 minutes.
Setting
The fitting of the LSO is generally performed in an outpatient clinic or specialized orthotics and prosthetics center.
Personnel
- Certified Orthotists
- Physical Therapists
- Physicians (Orthopedic or Spine Specialists)
Risks and Complications
- Skin irritation or pressure sores from prolonged wear.
- Discomfort if not correctly fitted.
- Muscle weakening if overused.
- Rarely, respiratory issues if the orthosis is too tight.
Benefits
- Improved stability and alignment of the spine.
- Reduction in back pain.
- Enhanced mobility and ability to perform daily activities.
- Faster recovery post-surgery or injury.
Recovery
- Patients may need to gradually increase the duration of wearing the brace.
- Regular follow-up appointments to assess the fit and effectiveness.
- Instructions on exercises to complement the use of the orthosis.
Alternatives
- Physical therapy and exercise programs.
- Medications for pain and inflammation.
- Surgical interventions for more severe cases.
- Other types of back braces or supports.
Patient Experience
- Initially, some discomfort or restriction might be felt, but this usually subsides as the patient gets used to the orthosis.
- Pain management typically involves over-the-counter pain relievers, if needed.
- Properly fitted, the LSO should feel supportive and not overly restrictive, allowing the patient to perform necessary daily activities with greater ease.