Name of the Procedure:

Addition to Cervical Thoracic Lumbar Sacral Orthosis (CTLSO) or Scoliosis Orthosis, Sternal Pad
HCPCS Code: L1050

Summary

This procedure involves adding a sternal pad to a CTLSO or scoliosis orthosis. The sternal pad is a component placed over the sternum (breastbone) to provide additional support and stability for the spinal orthosis device, which helps to correct or manage spinal curvature and abnormalities.

Purpose

The sternal pad is designed to enhance the functionality and effectiveness of the existing spinal orthosis, primarily used in patients with scoliosis or other spinal deformities. Its main goals are to provide additional pressure to the thoracic spine to improve spinal alignment and to prevent the worsening of spinal curvature.

Indications

The procedure is indicated for:

• Patients diagnosed with scoliosis or other spinal deformities requiring a CTLSO or scoliosis orthosis.
• Patients needing additional thoracic pressure and support to improve spine alignment.
• Individuals where conventional orthosis devices have not provided sufficient correction or support.

Preparation

• No special preparation such as fasting is required.
• The patient may need to undergo fitting assessments to ensure the orthosis and sternal pad will be properly aligned and effective.
• Any current medications and allergies should be reviewed to ensure they do not interfere with the procedure.

Procedure Description

1. Assessment: A healthcare provider evaluates the need for the sternal pad addition and measures the correct size and position for the pad.
2. Fitting: The patient wears the existing orthosis device, and the healthcare provider marks the optimal position for the sternal pad.
3. Attachment: The sternal pad is securely attached to the orthosis. This can involve screws, velcro, or other fastening methods to ensure it stays in place.
4. Adjustment: The device is adjusted as needed to ensure the patient’s comfort and the pad’s effectiveness.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

This procedure is normally performed in an outpatient clinic or an orthotic and prosthetic office.

Personnel

The procedure is typically conducted by:

• An orthotist, a healthcare professional specializing in orthotic devices.
• Occasionally assisted by a nurse or a physical therapist.

Risks and Complications

• Common Risks: Discomfort or minor pain at the site of the pad, temporary skin redness or irritation.
• Rare Risks: Pressure sores, improper alignment leading to ineffective support, or allergic reaction to materials used in the pad.

Benefits

• Enhanced support and correction for spinal deformities.
• Improved spinal alignment and comfort.
• Potential reduction in scoliosis progression.

Recovery

• The patient may experience initial discomfort, which typically subsides within a few days.
• Regular follow-up appointments ensure the orthosis fits well and functions correctly.
• The patient is usually advised to gradually increase wear time to get accustomed to the new pad.

Alternatives

• Modifications to the existing orthosis without a sternal pad.
• Custom orthosis designed specifically for the patient.
• Surgical options for severe scoliosis or spinal deformities.
  • Pros: Potentially more immediate and significant correction.
  • Cons: Higher risks and longer recovery periods associated with surgery.

Patient Experience

• During: Minimal discomfort; the fitting process is generally well-tolerated.
• After: Initial adjustment period where the patient may feel some pressure and discomfort. Mild pain management options like over-the-counter pain relievers may be recommended. Regular activity can typically be resumed with gradual increase in wear time.