Name of the Procedure:

Addition to Lower Extremity, Pelvic Control, Band, and Belt, Bilateral (L2640)

• Common Name(s): Bilateral Pelvic Control Band and Belt Addition
• Technical/Medical Term: Addition to Lower Extremity Orthosis, Pelvic Control Band and Belt, Bilateral (HCPCS L2640)

Summary

This procedure involves attaching a pelvic control band and belt to an existing lower extremity orthosis (a supportive device for the legs) to improve pelvic stability and control.

Purpose

• Medical Conditions Addressed: This procedure is typically performed to aid individuals with lower extremity weakness or instability that affects their pelvic region, often due to conditions such as paraplegia, muscular dystrophy, or severe lower limb injury.
• Goals/Outcomes: The main goals are to enhance stability and control of the pelvic region, thereby improving the overall balance and mobility of the patient.

Indications

• Symptoms/Conditions: Patients experiencing significant pelvic instability, difficulty in maintaining an upright posture, and increased risk of falls due to weak pelvic muscles.
• Patient Criteria: Suitable for individuals who already use lower extremity orthoses and require additional pelvic support.

Preparation

• Pre-procedure Instructions: Patients may be advised to wear comfortable clothing, ensuring the orthotic device can be accessed easily. No fasting or specific medication adjustments are typically required.
• Diagnostic Tests: An assessment by an orthotist or a physical therapist to evaluate the patient's need for the pelvic control band and belt.

Procedure Description

1. Initial Assessment: The healthcare provider performs a thorough assessment to customize the pelvic control band and belt based on the patient's needs.
2. Fitting: The pelvic band and belt are measured and adjusted to fit the patient's body precisely.
3. Attachment: The band and belt are securely attached to the existing lower extremity orthosis.
4. Adjustment: Fine adjustments are made to ensure comfort and optimal support.
5. Education: The patient is educated on how to wear, adjust, and maintain the newly added components.
   • Tools/Equipment: Customizable pelvic band and belt, tools for adjustment and fitting.
   • Anesthesia/Sedation: Not applicable.

Duration

The fitting and adjustment process typically takes about 1 to 2 hours.

Setting

This procedure is usually performed in an outpatient clinic or an orthotic and prosthetic facility.

Personnel

• Healthcare Professionals Involved: Orthotists, physical therapists, clinic staff.

Risks and Complications

• Common Risks: Minor discomfort during adjustment, temporary skin irritation.
• Rare Risks: Improper fit leading to pressure sores or increased instability. Close follow-up and adjustments can mitigate these risks.

Benefits

• Expected Benefits: Improved pelvic stability, enhanced balance, reduced risk of falls, and potentially greater independence in mobility.
• Timeline: Benefits are often realized immediately upon proper fitting and adjustment.

Recovery

• Post-procedure Care: Regular follow-up appointments for adjustments may be necessary.
• Recovery Time: Generally, no recovery time is needed as the procedure is non-invasive. Some patients might require a short period to adapt to the new device.
• Restrictions: Minimal restrictions, though patients are advised to monitor for signs of discomfort or skin irritation.

Alternatives

• Other Treatment Options: Physical therapy, core strengthening exercises, standalone pelvic supports.
• Pros and Cons of Alternatives: Physical therapy is non-invasive and beneficial for long-term muscle strengthening but may not offer immediate stability. Standalone supports can provide temporary relief but may not integrate seamlessly with an existing orthosis.

Patient Experience

• During the Procedure: Patients should expect minor adjustments and frequent feedback requests from the healthcare provider to ensure optimal fitting. Generally, the process is painless.
• After the Procedure: Initial discomfort may be experienced as the patient adapts to the new support. Pain management typically involves over-the-counter pain relievers and proper skin care to prevent irritation.