Name of the Procedure:

Addition to Thoracolumbosacral Orthosis (TLSO)

• Common Name: Low Profile TLSO with Anterior Thoracic Extension
• Medical Term: HCPCS Code L1220

Summary

In layman's terms, this procedure involves adding a low-profile anterior thoracic extension to a thoracolumbosacral orthosis (TLSO) to provide additional support to the patient's spine and torso.

Purpose

This procedure is intended to address conditions involving spinal instability or deformity, such as scoliosis, kyphosis, or post-operative stabilization needs. The goal is to improve spine alignment, reduce pain, and enhance mobility.

Indications

• Severe scoliosis or kyphosis
• Post-operative stabilization after spinal surgery
• Spinal fractures
• Conditions requiring additional anterior trunk support

Preparation

• Follow any specific dietary restrictions or fasting instructions provided by your healthcare provider.
• Adjust or cease certain medications if instructed by your doctor.
• Complete any pre-procedure diagnostic tests, such as X-rays or MRI scans.

Procedure Description

1. Initial Assessment: A healthcare professional will evaluate the fit and design of the existing TLSO.
2. Custom Fabrication: The anterior thoracic extension is custom-made to fit the patient’s anatomy.
3. Attachment: The extension is attached to the existing TLSO using fasteners and adjustments to ensure optimal fit and support.
4. Final Fitting: A final fitting session ensures that the added component aligns correctly and provides the necessary support.
   • Tools and Equipment: Custom orthotic materials, fasteners, measuring tools.
   • Anesthesia or Sedation: Not typically required.

Duration

The entire process, from initial assessment to final fitting, typically takes 1-2 hours.

Setting

This procedure is usually performed in an outpatient clinic or an orthotic specialist’s office.

Personnel

• Orthotist
• Orthopedic specialist (optional)

Risks and Complications

• Common: Discomfort or irritation at pressure points
• Rare: Skin breakdown, improper fit leading to inadequate support
• Management: Adjustments to the orthosis or additional padding can typically mitigate these issues.

Benefits

• Improved spinal alignment
• Enhanced stability and support
• Reduced pain and discomfort
• Benefits can often be felt immediately, with progressive improvement over time.

Recovery

• Follow post-fitting care instructions provided by your orthotist.
• Avoid strenuous activities initially, as advised by your healthcare provider.
• Schedule follow-up appointments for adjustments and checks.
• Typical recovery time varies but generally involves a period of adaptation lasting a few days to weeks.

Alternatives

• Other orthotic devices (e.g., rigid full-body braces)
• Physical therapy
• Surgical options for severe cases
• Non-invasive treatments such as chiropractic care
• Each alternative has its own pros and cons in terms of invasiveness, effectiveness, and recovery time.

Patient Experience

• During the Procedure: Typically minimal discomfort. Patients may feel pressure as the extension is applied.
• After the Procedure: Some initial discomfort or tightness is normal. Pain is usually managed with over-the-counter pain relief if needed.
• Comfort measures include regular adjustments and proper hygiene practices to prevent skin issues.