Name of the Procedure:

Lumbar-Sacral Orthosis (LSO), Sagittal Control
Technical Term: HCPCS L0643

Summary

This procedure involves fitting a lumbar-sacral orthosis (LSO), which is a type of back brace, to help control sagittal plane motion in the lower spine. It includes rigid posterior panels that extend from the sacrococcygeal junction up to the T9 vertebra and helps reduce the load on intervertebral discs by creating intrabdominal pressure. The brace features straps and closures for adjustment and might include additional supportive features.

Purpose

Medical Conditions:

• Lower back pain
• Lumbar sprain/strain
• Degenerative disc disease
• Post-operative stabilization

Goals:

• Stabilize the lumbar region
• Reduce pain and discomfort
• Support healing and recovery
• Prevent further injury to the lower spine

Indications

Symptoms/Conditions:

• Chronic lower back pain
• Weak or injured lower back muscles
• Post-surgical support for lumbar spine operations

Patient Criteria:

• Patients who require stabilization of the lumbar-sacral region
• Individuals experiencing significant pain relief through the use of support braces

Preparation

Pre-procedure Instructions:

• No specific fasting required
• Continue regular medications unless advised otherwise by your healthcare provider

Diagnostic Tests:

• Physical examination
• Imaging studies like X-rays, MRI, or CT scans to assess the condition of the lumbar spine if not recently done

Procedure Description

1. Assessment: The healthcare provider assesses the fit and adjusts the LSO to the patient's body.
2. Fitting: The orthosis is positioned and the straps and closures are fastened.
3. Adjustment: The healthcare provider ensures the orthosis is properly aligned and may make additional adjustments for comfort and support.

Tools and Equipment:

• Lumbar-sacral orthosis with rigid posterior panels
• Straps and closures for customization and fit

Anesthesia:

• Not required for this non-invasive procedure

Duration

Typical Duration:
Approximately 30 minutes for fitting and adjustment.

Setting

Procedure Location:

• Outpatient clinic
• Orthopedic office
• Rehabilitation center

Personnel

Healthcare Professionals Involved:

• Orthopedic specialist
• Physical therapist
• Trained orthotist

Risks and Complications

Common Risks:

• Skin irritation or pressure sores
• Discomfort or improper fit

Rare Complications:

• Restriction of breathing if fitted improperly
• Allergic reactions to brace materials

Management:

• Adjustments to the fit
• Use of padding or changing materials

Benefits

Expected Benefits:

• Immediate support and pain relief
• Improved stability for the lumbar region
• Enhanced functional mobility

Timeline for Benefits:

• Most patients experience benefits in a few days to weeks

Recovery

Post-Procedure Care:

• Properly wear the orthosis as instructed
• Avoid heavy lifting or strenuous activities

Expected Recovery Time:

• Varies depending on the underlying condition, generally a few weeks to months

Follow-Up Appointments:

• Regular check-ins to adjust the orthosis and assess progress

Alternatives

Other Options:

• Physical therapy
• Oral pain medications
• Surgical interventions

Pros and Cons:

• Physical therapy: non-invasive but slower results
• Oral medications: provide pain relief but with potential side effects
• Surgery: more invasive but may provide a more permanent solution

Patient Experience

During and After the Procedure:

• Mild discomfort during initial fitting
• Gradual adjustment period to wearing the brace

Pain Management:

• Any discomfort can often be managed by minor adjustments to the orthosis
• Over-the-counter pain relievers if necessary

Comfort Measures:

• Detailed instructions on how to wear and adjust the brace for optimal comfort