Name of the Procedure:

Addition to TLSO (Low Profile), Anterior Thoracic Derotation Pad (HCPCS Code: L1260).

Summary

This procedure involves adding an anterior thoracic derotation pad to a Thoracolumbosacral Orthosis (TLSO), which is a type of back brace. The pad is designed to improve the alignment of the spine by applying pressure to specific areas, helping to correct abnormal curvature.

Purpose

The procedure aims to address spinal deformities, such as scoliosis or kyphosis, by providing additional support and correcting misalignment in the thoracic region. The expected outcome is improved spinal posture and alignment, reduced pain, and prevention of further deformity.

Indications

• Scoliosis: Abnormal lateral curvature of the spine.
• Kyphosis: An excessive outward curvature of the spine, resulting in a hunchbacked appearance.
• Postural imbalance: Conditions leading to poor posture and back pain.
• Patient Criteria: Individuals who have been diagnosed with spinal deformities and require bracing as part of their treatment plan.

Preparation

• Pre-procedure Instructions: No fasting or medication adjustments are typically required.
• Diagnostic Tests: X-rays or MRI scans may be conducted to assess the degree of spinal curvature and guide the customization of the brace and pad.

Procedure Description

1. Preparation of TLSO: A customized TLSO brace is fabricated based on the patient's specific spinal curvature.
2. Attachment of Derotation Pad: The anterior thoracic derotation pad is securely attached to the TLSO brace.
3. Fitting: The patient is fitted with the modified brace, ensuring that the pad applies appropriate pressure to correct the spinal curvature.
4. Adjustment: Fine-tuning of the brace and pad is performed for optimal comfort and effectiveness.
   • Tools and Equipment: TLSO brace, derotation pad, and fitting instruments.
   • Anesthesia or Sedation: Not applicable, as this is a non-invasive procedure.

Duration

The fitting and adjustment process typically takes about 30 minutes to 1 hour.

Setting

This procedure is usually performed in an orthopedic clinic or a specialized brace-fitting center.

Personnel

• Orthotist: A healthcare professional specialized in designing and fitting orthopedic braces.
• Orthopedic Specialist: Physician specializing in musculoskeletal conditions may oversee the procedure.

Risks and Complications

• Common Risks: Minor skin irritation or discomfort.
• Rare Complications: Pressure sores or improper alignment leading to ineffective treatment.
• Management: Adjustments to the brace and pad can mitigate most issues.

Benefits

• Expected Benefits: Improved spinal alignment, pain relief, and prevention of further deformity progression.
• Timeline: Benefits may be noticed within weeks of consistent brace use.

Recovery

• Post-procedure Care: Regular follow-up appointments to monitor progress and adjust the brace as needed.
• Recovery Time: No downtime is required; patients can typically resume normal activities immediately with the brace on.
• Restrictions: Some physical activities may be limited based on individual patient needs.

Alternatives

• Other Treatment Options: Physical therapy, different types of spinal braces, or surgical intervention.
• Pros and Cons: Alternative braces may not provide the same level of correction; physical therapy is less invasive but may be slower; surgery is more definitive but carries higher risks.

Patient Experience

• During the Procedure: Patients will feel the fitting and adjustment process but no pain.
• After the Procedure: Initial discomfort as they adjust to wearing the brace; pain management includes over-the-counter pain relievers and ensuring proper fit for comfort. Continual use of the brace as prescribed will help maximize benefits and comfort.