Name of the Procedure:

Addition to Lower Extremity, Thoracic Control, Lateral Support Uprights (HCPCS Code L2680)

Summary

This procedure involves attaching additional support structures (uprights) to a lower extremity orthotic device to enhance thoracic (chest) control and lateral support. It helps improve stability and alignment for individuals who have difficulties in maintaining proper posture.

Purpose

Medical Conditions Addressed:

• Spinal cord injuries
• Neuromuscular disorders
• Severe muscle weakness

Goals:

• Improve posture and thoracic alignment
• Increase balance and stability while standing or walking
• Enhance overall mobility and functionality

Indications

Symptoms/Conditions:

• Inability to maintain proper thoracic posture
• Lateral instability when walking or standing
• Severe muscle weakness or neuromuscular disorders affecting the lower extremities

Patient Criteria:

• Evaluation by a healthcare professional confirming the need for additional support
• Individuals who already use a lower extremity orthotic device

Preparation

Pre-Procedure Instructions:

• No specific fasting or medication adjustments typically required
• Assessment by an orthotist for custom fitting
• Possible imaging studies or gait analysis to determine specific needs

Procedure Description

Steps Involved:

1. Assessment: Detailed evaluation of the patient's needs.
2. Fitting: Custom measurement for the support uprights.
3. Attachment: Secure the additional uprights to the existing orthotic device.
4. Adjustment: Fine-tuning for optimal thoracic control and comfort.

Tools/Equipment:

• Orthotic measuring tools
• Customizable support uprights
• Fastening and adjustment hardware

Anesthesia/Sedation:

• Typically not required

Duration

• The fitting and attachment process usually takes 1 to 2 hours.

Setting

• Orthotics and Prosthetics clinic
• Hospital-based orthotics department

Personnel

• Certified Orthotist
• Supportive medical staff (optional)

Risks and Complications

Common Risks:

• Skin irritation or pressure sores
• Discomfort or pain from improper fit

Rare Complications:

• Hardware malfunction or failure
• Possible worsening of posture if not fitted correctly

Management:

• Regular follow-up appointments for adjustments
• Immediate reporting of discomfort to the orthotist

Benefits

• Enhanced posture and stability
• Improved mobility and balance
• Increased independence in daily activities

Benefits Realization:

• Immediate post-fitting improvements with continued benefits as the patient adjusts

Recovery

Post-Procedure Care:

• Routine checks for skin integrity
• Gradual increase in use as tolerated by the patient

Recovery Time:

• No downtime; can usually resume normal activities immediately

Restrictions/Follow-up:

• Regular follow-up visits for adjustments and monitoring

Alternatives

Other Options:

• Physical therapy for muscle strengthening
• Other types of orthotic devices with different support mechanisms
• Surgery (in specific cases of severe instability)

Pros and Cons:

• Physical Therapy: Non-invasive but might be less effective alone for severe cases.
• Other Orthotic Devices: Varying degrees of support but may not provide the precise control needed.
• Surgery: More invasive with longer recovery but may offer long-term solutions in select cases.

Patient Experience

During the Procedure:

• Slight pressure while being measured and fitted
• Generally, non-painful process

After the Procedure:

• Period of adjustment to the new support structure
• Minor discomfort initially managed with adjustments
• Improved comfort and mobility over time