A Scoliosis Brace: The Ultimate Guide (2022)

A Scoliosis Brace: The Ultimate Guide (1)

When it comes to a progressive and incurable condition like scoliosis, the chosen treatment path is crucial. From traditional to alternative, current treatment strategies have evolved to combine the benefits of multiple modalities. Scoliosis bracing has been around since the condition’s early days, and while there are many different braces to choose from, not all are created equal. The big difference is whether or not a brace is designed to ‘hold’ or ‘correct’ the scoliosis.
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If you or someone you love has recently received a recommendation to wear a scoliosis brace, there is a lot of information to wade through. In an effort to better understand the pros and cons associated with different types of scoliosis braces, please continue reading so you can make the most informed decision possible.

Table of Contents

The Role of Scoliosis Bracing in Treatment

Bracing is a common facet of scoliosis treatment in children and adolescents; this is because bracing only works if a spine is still growing. It’s most often prescribed for patients with a Cobb angle measurement of 20 or 30 degrees.

As a progressive condition, a large part of any treatment strategy is controlling the level and rate of progression. With many of the traditional bracing options, the purpose of the brace is to reduce the likelihood of the scoliosis worsening and avoid the need for spinal-fusion surgery. The theory behind bracing is that if pressure is placed on the parts of the spine with bad curves, that pressure will stop those bad curves from growing, controlling their progression.

Depending on condition severity, treatment approach, and the type of brace being used, some braces require constant wearing, others are worn at night, and some are worn for large portions of the day. Considering the age group most commonly diagnosed with scoliosis, adolescents 10 to 18 years of age, you can see how compliance can be a challenge.

Before we move on to the differences between individual braces, I want to draw attention to the biggest overarching difference that impacts efficacy: the difference between a brace that ‘holds’ the scoliosis and a brace that ‘corrects’ the scoliosis.

Holding vs. Correcting

If you’ve done your homework, you’ve likely come across the two terms ‘holding’ and ‘correcting’ when reading about scoliosis treatment options. While they might seem similar, in terms of treatment efficacy, they mean very different things.

Holding the Spine

The idea behind a lot of traditional bracing and invasive spinal-fusion surgery is to ‘hold’ the spine in a straighter alignment. In terms of making a crooked spine straighter, these methods can be considered successful, but what I want to caution patients and their families about is that a straighter spine held in position can come at a cost; that cost is the spine’s overall strength and flexibility.

The other thing I’d like to point out is that holding the spine in a straighter alignment is doing little to address the actual underlying cause of the deformity and is, instead, just addressing the curvature as a symptom of it.

Correcting the Spine

The difference between holding and correcting is significant. When a crooked spine finds its way back to a straighter alignment through corrective means, the spine’s been manipulated to move in the ways we want it to.
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Whether this is accomplished through chiropractic adjustments, corrective bracing, scoliosis-specific exercises and therapy, or a combination of everything, the end result is a spine that’s experienced a correction through natural and functional means; it’s not being held in a better position through artificial means.

Manipulating the spine to move into a corrective position means the spine doesn’t lose its natural strength and flexibility, as it does when it’s simply being held in position.

Because children and adolescents are still growing, they face the highest risk of progression, and also because they’re still growing, their spines can respond favorably to scoliosis bracing as a means of preventing progression from getting worse.

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Scoliosis Bracing for Kids

If you’ve done some reading about scoliosis, you’ve likely stumbled across the term ‘early detection’. As a progressive condition, it’s in the very nature of scoliosis to worsen over time; as an incurable condition, treatment efforts are aimed at controlling its progression so that patients can live their best lives throughout treatment and beyond.

When it comes to treating children and adolescents with scoliosis, we want to monitor them closely to see how growth affects their progression. As the number one trigger for progression, growth is obviously not something we can stop from happening, but we can certainly make every effort to counteract the condition’s natural tendency to worsen along with it.

Scoliosis bracing is a common treatment option for kids because they’ve yet to reach skeletal maturity, meaning their spines can still be manipulated to varying degrees. For moderate-to-severe conditions, or when rapid progression is a concern, bracing can be recommended as a means of slowing down progression.

Through a three-point pressure system, traditional braces put pressure on parts of the curvatures we don’t want to keep growing. That squeezing effect, in theory, can slow down progression.

Again, this isn’t doing anything to actually correct the curvature, only to hold it in a corrective position. While bracing is more commonly recommended for younger patients, scoliosis bracing for adults also has its place.

Scoliosis Bracing for Adults

Scoliosis bracing for adults is less commonly prescribed as they’ve already reached skeletal maturity. Another reason is that as growth is no longer a factor with adult patients, rapid progression is not as much of a concern.

When it comes to bracing for adults, if recommended, it’s for different reasons than with younger patients. In younger patients, bracing is mainly recommended to limit progression; in older adults, it’s most often prescribed to reduce pain and limit the need for medication.
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If an adult with scoliosis is in severe pain, some doctors will prescribe a scoliosis back brace to help reduce their patient’s spinal movement and provide them with support. Depending on the cause and severity of the patient’s condition, bracing recommendations will vary significantly.

That being said, there are two common types of scoliosis braces recommended for adults:

  • Rigid bracing - in older adults, hard plastic braces are shied away from as they can cause muscle atrophy and related complications that can accelerate degeneration of the spine.

Younger adults sometimes opt for a rigid brace to improve their spine’s overall appearance.

  • Flexible bracing - flexible braces are most often recommended for adult patients in need of extra back support and palliative relief during strenuous physical activities.

These are sometimes used for their rehabilitative potential in strengthening the body’s posture for long-term relief.

Now that we’ve looked into the different ideologies behind scoliosis bracing in general, and scoliosis bracing for children and adults, let’s explore some of the defining features of the most popular braces: TLSO Boston brace, Milwaukee brace, Charleston Bending brace, and the ScoliBrace®.

The TLSO Brace

TLSO (thoracic-lumbosacral-orthosis) braces are corset in style and are most often pre-made out of rigid plastic. It focuses on the mid-to-lower spine in order to stabilize the lateral bend of a scoliosis curvature.

The brace comes in small, medium, and large, and the most common TLSO brace design is the Boston brace; this is the most common scoliosis brace used in the United States. It wraps around the patient’s rib cage, hips, and lower back and has to be worn virtually all day: 18-23 hours.

As you can imagine, wearing a Boston brace isn’t comfortable. In fact, it’s designed to be uncomfortable, in part, so that the patient’s body stops the progression.

This is where compliance can become an issue. Imagine a 15-year-old girl wanting to wear a rigid brace all day that restricts her range of motion and can also impair lung function. Let’s also keep in mind that the brace only fits under clothing that’s baggy enough - not exactly in line with the day’s big fashion trends.

Often, once teenagers get to school, that brace comes off and goes in the locker. If the brace isn’t worn the way it's supposed to be, success rates drop significantly.

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Milwaukee Brace

Known as a CTLSO (cervico-thoraco-lumbo-sacral-orthosis) brace, the Milwaukee brace resembles a bulky plastic body jacket and is most often used for treating high thoracic (middle back) curves.

It functions in the same way that many lower-back braces do, with the exception of having a neck ring. The neck ring’s held in place through vertical bars that are attached to the main body of the brace.

This type of brace is most effective for curves in the thoracic spine and is regarded as particularly effective when it comes to kyphosis (an excessive outward curve).

The Milwaukee brace should be worn for 23 hours a day to decrease the likelihood of curvature progression, and there are also braces that are designed to be worn only at night.

Charleston Bending Brace

The Charleston Bending brace is designed to be worn at night so that adolescents can reduce their thoracolumbar curves while sleeping. Developed in the 1970s, this brace makes a decent attempt at addressing the compliance issue that sabotages many bracing treatment attempts.

However, the flip side of that is the brace is only designed to be used while in a lying-down position, and many question just how effective it can be when worn only in that one position for a limited amount of time a day.
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The Charleston bending brace is molded so that it will conform to the wearer’s body while they’re bent towards their curve’s outward bulge.

The other big issue with this is that it only addresses the bending associated with the scoliosis, not the rotation, and we know that as a 3-dimensional condition, any effective treatment plan has to treat the curvature on all three planes: frontal, coronal, and sagittal.

Treating scoliosis as a 2-dimensional condition, rather than 3-dimensional, is a major shortcoming of traditional scoliosis bracing in general.

Shortcomings of Traditional Scoliosis Bracing

As mentioned earlier, scoliosis braces are still one of the most common forms of treatment for the condition. While some people would take that as evidence of their efficacy, this is where it’s important to do your own due diligence.

The aforementioned braces don’t address the condition’s nature as 3-dimensional; instead, they treat it as 2-dimensional.

In fact, traditional braces such as the Boston and the Milwaukee can do a fair amount of harm due to their squeezing designs.
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As the braces are designed to squeeze the spine so that it slows down the bad curve’s progression, that pressure can cause a gradual weakening of the spine.

Anything that weakens an already deformed spine isn’t good in the long-term.

There’s also a growing concern amongst experts that the Boston brace can actually increase the spine’s overall rigidity.

In addition, as most of the squeezing pressure from the brace comes from the sides, rib deformities that are already characteristic of scoliosis can worsen.

Of course, there are also the financial costs associated with getting a scoliosis back brace, and depending on budget, this factor alone could decide whether or not a scoliosis back brace is a viable treatment option.

Scoliosis Brace Cost

When considering different paths of treatment for scoliosis, financial cost should also be considered. When it comes to bracing, the average cost of a traditional scoliosis back brace can vary depending on the design.

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Most often, traditional braces will range in price from $5,000 to $10,000. It’s important to remember that this is solely the cost of the brace; this doesn’t include the cost of having the brace fitted, X-rays taken, and any other associated fees. For the more current and innovative ScoliBrace®, the average cost is $4,600.

For people weighing the pros and cons of various forms of treatment, in addition to considering the efficacy of traditional scoliosis bracing, there is also the financial cost and the emotional and physical challenges associated with wearing a brace that can be uncomfortable and cumbersome.

Not a Perfect Fit

A big problem with traditional scoliosis bracing is that they’re not custom fit to each and every patient. While certain adjustments can be made and most braces have size options of small, medium, and large, those standardized sizes most certainly can’t be considered custom.

Considering that the braces have to be worn for most of the day, imagine how something that’s not tailored to your body could make you look and feel. Now, also imagine you’re an insecure tween or teenager dealing with all the rigors and emotional upheaval of day-to-day life, plus a progressive and incurable spinal deformity.
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Basically, they see their curvature continuing to worsen and, more importantly, they feel it. That pain and discomfort, paired with how they look and the mobility restrictions they’re faced with, often simply becomes too much. If the brace is considered too painful, uncomfortable, embarrassing, or limiting, many patients refuse to wear it.

Much like teenagers who get their orthodontic braces yanked off too soon because they can’t see the end result through the challenges, regardless of how effective a treatment option is, if it’s not sustainable, it ends up wasting time and resources.

Now, after reading all this, you might be thinking there’s little point to even considering scoliosis bracing as a treatment option. I’m here to tell you that there’s a new brace for a new era of scoliosis correction, and you’re going to want to read all about it.

The ScoliBrace®: What Makes it Different

When it comes to modern scoliosis correction technology, I have to point out that the vast majority of traditional scoliosis braces were designed in the 70s. While some tweaks have been made over the years, the overall design remains the same; this is a major shortcoming.

It’s not the theory behind scoliosis bracing that I take issue with; it’s the many shortcomings of the actual braces that I feel are unnecessary. I felt there had to be a better approach to scoliosis bracing, one that could actually improve the condition, rather than just ‘hold’ it.

Here at the Scoliosis Reduction Center, we wanted to give our patients another option that could deliver positive results through curvature reduction and functional improvement.

I touched on it earlier, but the big difference between traditional scoliosis braces such as the Boston and the Milwaukee and the ScoliBrace® is this: the former treats the condition as if it’s 2-dimensional, while the latter addresses its true 3-dimensional nature.

The ScoliBrace® Treats Scoliosis as a 3-Dimensional Condition

A true scoliosis doesn’t just bend, it rotates, and that’s why it’s considered a 3-dimensional condition; any treatment strategy that doesn’t address it as such will fall short.

The other big difference between traditional bracing and the over-corrective ScoliBrace® is that the ScoliBrace® is classed as ‘ultra-corrective’ bracing, meaning it’s designed to actually reduce the scoliosis while it’s being worn.

The ScoliBrace® is custom manufactured and 100-percent bespoke to each and every patient. Picture shelling out big bucks for a finely-made Italian suit. The tailor measures each and every inch of your body, and the care and intricate detailing that goes into the final measurements results in a suit that’s 100-percent customized to suit your body type and all of its curves; our custom ScoliBrace® is much the same.
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We’ve taken the very best corrective principles from other bracing designs and combined them with BraceScan: an advanced and modern 3D imaging software. With BraceScan, we take multiple scans of the patient’s body and spine to ensure a completely customized fit for each and every ScoliBrace®.

My treatment plans don’t always necessitate the use of scoliosis bracing, but when a patient’s condition dictates that necessity, the corrective ScoliBrace® is by far the best choice.

Combined with other forms of treatment such as chiropractic adjustments and scoliosis-specific exercise and therapy, the ScoliBrace® represents a new era for scoliosis treatment: one I’m very excited to be a part of.

Conclusion

Scoliosis is a complex condition. From causation to progression, it’s a condition that often has the medical community scratching its head in search of answers and understanding.

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Although we might not understand every variable that affects its development and progression, we’ve come up with a solid foundation from which to develop the best possible scoliosis treatment plans.

When it comes to bracing as a form of scoliosis treatment, there have been a lot of advancements made from the early designs, and those advancements have culminated in the ultra-corrective ScoliBrace®.

The ScoliBrace® uses the ideology behind traditional bracing and addresses its shortcomings by treating the condition as 3-dimensional and making the brace more comfortable, customized, and corrective.

Rather than just holding the spine in a corrective position as the traditional braces do, the ScoliBrace® actually works to move the spine into a corrective position while it’s being worn.

When combined with other forms of proactive treatment, the ScoliBrace® can have impressive results in terms of controlling progression and correcting a curvature without compromising the spine’s natural strength and flexibility.

A Scoliosis Brace: The Ultimate Guide (10)More About MeContact Us

Dr. Tony Nalda
Doctor of Chiropractic

Severe migraines as a young teen introduced Dr. Nalda to chiropractic care. After experiencing life changing results, he set his sights on helping others who face debilitating illness through providing more natural approaches.

After receiving an undergraduate degree in psychology and his Doctorate of Chiropractic from Life University, Dr. Nalda settled in Celebration, Florida and proceeded to build one of Central Florida’s most successful chiropractic clinics.

His experience with patients suffering from scoliosis, and the confusion and frustration they faced, led him to seek a specialty in scoliosis care. In 2006 he completed his Intensive Care Certification from CLEAR Institute, a leading scoliosis educational and certification center.

About Scoliosis Reduction Center

Welcome to Scoliosis Reduction Center. Our team, under the leadership of Dr. Tony Nalda, is focused on treating your scoliosis in the most patient-centered, effective manner possible.

(Video) Peak Scoliosis Bracing System - Provider Inservice Training Video (New One Size Adjustable)

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FAQs

Do scoliosis braces actually work? ›

About scoliosis bracing

Of these patients, about 75 percent are successfully treated with scoliosis bracing. The other 25 percent go on to need spinal fusion surgery. Orthopedic doctors typically recommend scoliosis bracing for kids and teens who are still growing and have a curvature of 25 degrees or more.

What is the most effective scoliosis brace? ›

The most-commonly prescribed brace for scoliosis today is the Boston brace. Many people know the Boston brace as a type of thoracic-lumbar-sacral orthosis (TLSO).

How long do you wear a scoliosis brace? ›

Bracing for Adults with Scoliosis

Depending on the size of the patient's curve and the rigidity of their spine, this would mean wearing the brace for 6 to 18 months and then weaning them down from wearing a corrective to a traditional supportive brace, or completely out of bracing.

How many hours a day do you have to wear a back brace for scoliosis? ›

How long do I have to wear the brace? The brace needs to be worn 23 hours each day until the team determines that the patient has reached skeletal maturity. At that point, you might be switched to wearing the brace at night only.

How can I fix scoliosis naturally? ›

Mild scoliosis is often managed simply with exercise, medical observation, scoliosis-specific physical therapy, and chiropractic treatment from a chiropractic scoliosis specialist. For some people with scoliosis, yoga or pilates is also recommended to decrease their pain level and increase flexibility.

How many hours a day should you wear a back brace? ›

For it to be effective, the brace may need to be worn as much as 23 hours every day until the child stops growing. As the child grows, they will spend less time wearing the brace and will no longer need the brace once they are mature. Other conditions that may benefit from wearing a back brace include: Lower back pain.

Is scoliosis a disability? ›

This sideways curvature of the spine can have many side effects and health problems. So, the Social Security Administration (SSA) offers benefits for scoliosis disorder. If you are wondering whether scoliosis is a disability, the answer is YES! It is a disability, and you can get disability benefits for it.

What do you wear with a scoliosis brace? ›

Long button down shirts, sweaters, loose tank tops, and long hoodies all conceal not only the bottom of the brace, but the shape of the shirt can conceal the boxiness of a symmetrical brace or the over correction of our Chêneau brace: the Chêneau Gensingen®.

How do you go to the bathroom with a scoliosis brace? ›

Bras without underwire may be more comfortable. To make using the bathroom easier while wearing the brace, wear your underwear over the brace.
...
  1. Each brace includes a dime-sized sensor that is placed inside.
  2. The sensor monitors temperature, so when the brace is being worn, the sensor is at body temperature.
Jun 21, 2022

Can you sleep on your side with a scoliosis brace? ›

Side sleeping is preferable for people with scoliosis because it keeps your spine in a straight and neutral position, which will make sleeping more comfortable as there will be less strain on your spinal nerves.

Can you wear a scoliosis brace under your clothes? ›

You'll wear your brace under your clothes, so anything that fits over your brace should be fine. Most people find loose-fitting clothes to be more comfortable over the brace, so you may want to consider wearing clothes a size or two larger than usual.

How uncomfortable is a scoliosis brace? ›

It's normal for a brace to be uncomfortable for the first couple of weeks, but the brace shouldn't hurt. If it does, the family probably needs to go back to the orthotist to have it adjusted. Also, the patient's skin should not be red or blistering. If it is, we'll work on that.

When does scoliosis stop progressing? ›

In most cases of idiopathic scoliosis, the curve develops around the time the patient hits puberty, then continues to progress throughout their adolescence until their spine has finished growing (usually at age 16-18).

How much does a scoliosis brace cost? ›

The cost of a traditional scoliosis brace varies widely depending upon the design but generally ranges from $5,000 to $10,000. This does not include the cost of the doctor fitting the brace, x-rays taken in the brace or other associated fees—which, according to research, average around $10,836 annually.

What are the 3 types of scoliosis? ›

Most experts feel there are three categories of scoliosis. idiopathic, congenital, and neuromuscular. Idiopathic is the most common type of scoliosis. This means that the cause is unknown or that there is no single factor that contributes to the development of the disease.

What benefits can I claim with scoliosis? ›

You may be able to claim the daily living component if your scoliosis makes it difficult for you to carry out routine tasks such as bathing, getting dressed, and preparing meals; the mobility component could be available to you if your curved spine prevents you from getting around easily.

What jobs can I do with scoliosis? ›

Need inspiration? Here are 8 jobs for people with scoliosis, ankylosing spondylitis and other spinal disorders:
  • Teacher.
  • Self-employed. ...
  • Exercise instructor. ...
  • Sales agent. ...
  • Reseller. ...
  • Mindfulness coach. ...
  • Administrative assistant. ...
  • Project manager.
Oct 8, 2020

Does wearing a back brace help scoliosis? ›

The Goal of Bracing

A scoliosis curve usually does not improve without surgery. However, studies have shown that wearing a back brace as prescribed can often prevent the progression of scoliosis. As such, wearing a brace can be an effective way to keep a scoliosis curve's Cobb angle relatively small and manageable.

Can adult scoliosis be corrected with a brace? ›

Scoliosis braces aren't just limited to adolescent use; they can be used in cases of adult scoliosis if they are designed properly and accompanied with a proactive patient program that keeps the spine straight and strong.

Is a scoliosis brace uncomfortable? ›

Your brace will feel uncomfortable at first, but over time you will adjust to it. Some teens even say they miss wearing the brace after their treatment ends. Keep in mind that your brace is temporary.

Should adults wear scoliosis brace? ›

The best medical practitioners around concluded that scoliosis braces for adults are the most beneficial option for the cases that don't require surgery. Before choosing your scoliosis brace, arrange an examination with your doctor so that you can make the right decision.

How do adults straighten out scoliosis? ›

Surgical treatment

Surgery is necessary in some cases of adult scoliosis. This treatment is the last option because of the risks of complications from spinal surgery.

Does scoliosis worsen with age? ›

Scoliosis is a progressive condition – it does tend to get worse as you age. However, scoliosis is somewhat unusual in that it does not have what we might call a “predictable trajectory” – this is to say that you cannot simply assume that after X years, scoliosis will have increased by X degrees.

Can a chiropractor fix scoliosis? ›

A chiropractor for scoliosis can develop a non-invasive, drug-free scoliosis treatment plan that addresses multiple symptoms. While chiropractors are unable to straighten your spine completely, studies have shown a marked improvement in spine curvature, pain, and disability rating among those with scoliosis.

Click on the Link to Find Out More About Best Back Brace for Thoracic Compression Fracture

The following are the best eight back brace for thoracic compression fracture if you are looking for one.. The Thoracic Lumbosacral Support Brace gives back muscle support and stability, helps correct the spine, and reduces discomfort and back spasms.. The Brace Align TLSO Full Body Back brace provides back support and promotes optimal spinal alignment.. With a simple-to-use pulley tab and pulley system that compresses your belly, diverts pressure away from your spine, and relieves discomfort, this back brace for thoracic compression fracture provides you easy and comfortable control.. The TLSO Medical Lumbar Back Brace is frequently recommended to patients as an analgesic option for postoperative support, kyphosis attributable to osteoporosis, degenerative disc disease, ruptured or bulging disc, fracture management, and other spine disorders.. With frequent wear, this best back brace for thoracic compression fracture is constructed of a lightweight, breathable material that keeps you cool and comfortable.. This Posture Extension Back Brace is designed to alleviate discomfort caused by a variety of thoracic spine illness, muscle strains, compression fractures, and other conditions.. Because of the postural extension and abdominal compression that this support provides, the spinal support posture is well-suited to the treatment of a variety of thoracic back ailments and injuries.. This lumbar brace Multi-layer aluminum alloy rivet strap structure with quality breathable composite fabric to adjust and support the trunk, better spinal stability, less weight, and more comfortable than typical TLSO back brace.. Lower and middle back pain caused by scoliosis, osteoporosis, bad posture, hypotension, vertebral compression fractures, spinal stenosis, mechanical back pain, and other conditions is treated.. The back brace is indicated for patients with acute or chronic back pain associated with sprains, strains, degenerative disc disease, bulging or herniated discs, and other problems involving the vertebral body.. This best back brace for thoracic compression fracture has unique features that provide compression, stability, and support to your muscles, reducing pressure on the spine and hips, reducing inflammation, and improving posture and alignment.. The Brace Align back brace supports flexion and extension and allows for more lateral movement.. ORTONYX Full Back Support Brace is the best back brace for thoracic compression fracture I will recommend to anyone looking for a brace that gives muscle support and stability while helping to correct the spine, and reduces discomfort and back spasms.

If you’re thinking about buying a new set of pillows but aren’t quite sure how you can go about getting rid of your old pillows, read on!

If you’re thinking about buying a new set of pillows but aren’t quite sure how you can go about getting rid of your old pillows, this post is for you.. Animal shelters use pillows as beds for their animals, so they’ll most probably welcome your donation.. You’ll just drop your old pillows off at a textile recycling facility and they’ll take it from there.. You might be thinking that since pillows can be recycled, you can just drop them at a recycle bin.. However, not all recycling facilities agree to recycle textiles like pillows and mattresses.. One of the facilities that welcome recycling pillows is the American Textile Recycling Service.. Throwing the old pillows in a trash bin or landfill should be your last resort since it renders the pillows completely useless and is the least eco-friendly option to dispose of your old pillow.. Old pillows can also be repurposed into comfy pet beds, floor or knee cushions, draft stoppers, and others, so you should certainly think twice before making the decision to dispose of them.

Number: 0411

The member meets medical necessity criteria for lumbar spinal fusion in CPB 0743 - Spinal Surgery: Laminectomy and Fusion ; and INFUSE Bone Graft is to be used with a cage (for example, the MedtronicTitanium Threaded Interbody Fusion Device, the LT-CAGE Lumbar Tapered Fusion Device, or the INTER FIX or INTER FIX RP Threaded Fusion Device); and INFUSE Bone Graft and device is to be implanted via an anterior (ALIF) or lateral (OLIF, DLIF, XLIF or LLIF) approach.. Acell biologic graft Acellular human dermal allograft (e.g., Alloderm and Arthrex allograft) for nasal septal repair Actifuse silicated calcium sulphate as bone graft substitute Adipose-derived stromal vascular fraction cells Anterior cruciate ligament-derived stem cells for ligament tissue engineering Anti-microbial bone graft substitutes for the treatment of osteomyelitis Arthrex biopaste (BioCartilage) for glenoid osteochondral defects and other indications Arthrex Quickset (calcium phosphate cement) Autologous stem cells for use after screw removal in orthopedic surgery Avive tendon wrap Bioglass 45S5 and other ceramic products (except for beta tri-calcium phosphate (b-TCP) for spine fusions) BIO MatrX as bone graft substitute BioD Restore (placental tissue graft) Cerament bone void filler ChronOS beta tri-calcium phosphate bone graft substitute for indications other than spinal fusion Collagen-based bio-inductive implants (e.g., Regeneten) for repair of rotator cuff tears Cook anal fistula plug DeNovo NT natural tissue (allogeneic minced cartilage) graft EmCell (fetal stem cell therapy) Genetically corrected autologous epidermal grafts for the treatment of recessive dystrophic epidermolysis bullosa Gore anal fistula plug Gracilis cadaveric graft for hallux valgus repair Human growth factors (e.g., fibroblast growth factor, insulin-like growth factor) to enhance bone healing i-Factor peptide enhanced bone graft Kartogenin-treated autologous tendon graft Knee Creation nanocrystalline calcium phosphate bone substitute Ligament and Joint Regeneration and Neuvo-generation Medicine (LaJRaN) Mastergraft putty in spinal surgeries MCS Bone Graft Nacre (mother-of-pearl) NanOss Bioactive/nanOss Bioactive 3D in spinal surgeries OssiMend putty in spinal surgeries Osteofuse (for the treatment of delayed unions and nonunions and for use in spinal fusions) OsteoVive ProDense (calcium sulfate/calcium phosphate composite) as bone graft substitute Rybone SureFuse (DBM containing growth factors) Surgisis collagen plug for the treatment of anal fistulas SXBarrier (Surgilogix) (placental tissue and growth factors) Tendon Wrap Tendon Protector Tooth-bone graft Vivex Via graft (Amendia) (contains stem cells).. Kang, et al. (2012) conducted a 2-year prospective, multicenter, randomized controlled clinical trial comparing the outcomes of Grafton demineralized bone matrix (DBM) Matrix with local bone with that of iliac crest bone graft (ICBG) in a single-level instrumented posterior lumbar fusion.. Fusion was defined as any radiographic evidence of bridging across endplates, or bridging from endplates to interspace disc plugs; 80 % of patients had evidence of fusions at 6 months, 98 % of patients had evidence of fusions at 12 months, and 100 % of patients had evidence of fusions at 18 months.. In this study these researchers examined if rhBMP-2 treatment would increase the rate of successful ankle fusion in complex patients (patients with co-morbidities associated with poor surgical healing) compared with a control group of patients undergoing ankle fusion who did not receive rhBMP-2; would reduce total time wearing a frame when compared with the control group; would result in a difference in the percentage of bone bridging between the group treated with rhBMP-2 and the control group, as determined by CT scans 3 months after surgery; and would encounter an equal rate of complications different from untreated patients.. Studies using the OsteoProbe showed differences in bone material strength index (BMSi) between patient populations, including a decrease in BMSi in type 2 diabetic patients compared to non-diabetic patients, as well as an increase in BMSi of glucocorticoid-treated patients compared to non-treated patients.. These researchers compared post-operative radiographic and clinical outcomes of patients suffering from a complex tibial plateau fracture (TPF) fixed with calcium-phosphate bone substitutes (CPBS) augmentation to a matched group of patients with identical fracture pattern, treated with the same fixation's type, but augmented with bone grafting.. This prospective, randomized, controlled clinical study examines the differences in pain, quality of life (QOL), and cost of care in the treatment of tibia plateau fractures-associated bone defects using either autologous bone grafting or bioresorbable hydroxyapatite/calcium sulphate cement (Cerament bone void filler [CBVF]).. The authors preliminary concluded that CBVF can be successfully used as a bone substitute in patients with various bone diseases, as well as benign bone tumors; CBVF can provide an effective and long-term solution for reconstructive procedures following curettage of bone tumors and tumor like lesions.. This systematic review also compared the fusion rates between ceramic-based grafts used in different surgical approaches, namely PLF and circumferential fusion combining interbody fusion with posterior instrumentation -- anterior lumbar interbody fusion (n = 4 studies), posterior lumbar interbody fusion (PLIF) (n = 6 studies), and transforaminal lumbar interbody fusion (n = 2 studies).. 3D Profuse (ATEC Spine) Accell Connexus (SeaSpine) Accell Evo 3 (SeaSpine) Accell TBM (SeaSpine) ACF (DePuy Synthes) Allocraft CL (Stryker) AlloFlex (Allosource) AlloFuse (Allosource) AlloGro DBM (Allosource) AlloPac (Allosource) AlloSource Femoral Head Bone Graft (Allosource) AlphaGraft DBM (ATEC Spine) AlloQuent (Orthofix) Atrix-C (Xtant Medical) Autograft (patient) Berkeley Advanced Biomaterials allograft (excludes the TCP versions) Bio DBM (Stryker) BioAdapt Bridge (Surgalign) BioMet Boost DBM BioMet DBM putty BioMet EBI DBM BioReady DBM Putty (Surgalign) BioReady DBM Putty with Chips (Surgalign) BioSet Allograft (Surgalign) BioSet DBM (Surgalign) BonePlast Quick Set Cadaveric Allograft Capistrano (SeaSpine) CeSpace Bone (Aesulap) Conform Sheet (DePuy Synthes) Cornerstone ASR (Medtronic) Cornerstone L-ASR (Medtronic) Cornerstone-SR Allograft Tissue (Medtronic) (not allowed in the cervical spine if INFUSE is used as part of the graft) DBM Pure Macro allograft (LES Spine/SpinalFrontier) DBM Pure Micro allograft (LES Spine/SpinalFrontier) Demineralized Bone Matrix Dense cancellous bone allograft DynaGraft-D (Cigagenix) Dynagraft II DBM (SeaSpine) Elemax cortical spacer allograft (Surgalign) Evologics DBM Exponent DBM (Bioventus) Fortitude Duo (Zimmer Biomet) Fortitude Osso (Zimmer Biomet) FusionFlex (Wright Medical) Grafton Crunch, Flex, Gel, Matrix, Orthoblend (Large or Small Defect), Putty, Strips (Medtronic) IC Graft Chamber (LifeNet Health) Impacted cortical bone INFUSE Bone Graft (Bone Morphogenic Protein-2) (Medtronic) (See Section I in the policy section for exclusions) Integra DBM InterGro DBM (Zimmer Biomet) Kore Fiber (MTF Biologics; offered/marketed by KolosisBIO) Magnifuse (Medtronic) MTF cube (Musculoskeletal Transplant Foundation) MTF Cortico/Cancellous ACF spacer (Musculoskeletal Transplant Foundation) MTF DBX (Musculoskeletal Transplant Foundation demineralized bone matrix) Optecure DBM (Exactech) Optefil (Rti Surgical) Opteform DBM (Exactech) Optium (LifeNet) Oragraft (LifeNet) Osprey Condor, Eagle, Talon (Skye Biologics) OsteoAMP (Bioventus) OsteoAMP Select (Bioventus) Osteofil DBM Osteogenic Protein-1 (OP-1) Osteo-link DBM (Life Spine) OsteoSelect (Xtant Medical) OsteoSparx DBM (SeaSpine) OsteoSponge DBM (Xtant Medical) Osteostrip (Alliance Spine) Osteosurge 100 DBM (SeaSpine) Osteosurge 300 (SeaSpine) Pinnacle DBM sponge Polymethylmethacrylate (PMMA) Antibiotic Beads Prime DBM HD (Musculoskeletal Transplant Foundation; offered/marketed by KolosisBIO) Progenix Plus (UMG Uysal Medikal) Progenix Putty (UMG Uysal Medikal) Promote Osteostrip (Alliance Spine) Promote Osteopro (Alliance Spine) Propel DBM (NuVasive) PureBone (Biventus) Puros DBM (Zimmer Biomet) RTI Biologics BioSet Allograft Paste RTI DBM Powder Skye Biologics DBM cancellous bone allograft (chips, crunch, cubes, paste, putty) SteriSponge (offered/marketed by Bio-Implant Solutions) Staygraft DBM SteriFuse (Aurora Spine) Triad Allograft (NuVasive) Tricortical bone allograft Trinnect (Zimmer Biomet) VegaGraft (GS Medical) Vertigraft (LifeNet) Vertigraft II (LifeNet) Vesuvius fibers DBM (Stryker) VG2 cervical allograft (LifeNet) Xemplifi DBM (Globus Medical) Wright Allomatrix DBM C, DR Wright Allopure Wright Ignite.. Accufill Acuity Allostem Actifuse Activize Nucel AlloGro Stem Cell Bone Growth Substitute Allosource AlloStem Alphatec NeoCore beta tricalcium phosphate (experimental for indications other than spinal fusion) Alphatec VELOSSITY Moldable Synthetic Bone Graft Amniofix AmnioShield Arteriocyte \ Magellan Platelet Separator Systems Augment Beta-BSM Bioactive graft (nano-structured hydroxyapatite material) BioD factor Biogennix RPC BioMatrix Generate BioSphere Putty Bioactive Bone Graft BiOstetic BioViable Bone Matrix BonAlive BoneSave BoneSource BVF Bone X'TRUDABLE BonePlast Calceon 6 Callos Bone Void Filler CarriGen Cartimax Cellentra Allograft Celling Biosciences Solum IV allograft Cem-Ostetic CLM Bioactive Scaffold CONDUIT TCP Granules CopiOs Bone Void Filler (Zimmer Biomet) Cortiva acellular dermal matrix Cyclone Bone Marrow Concentrate system Equivabone Graft (Zimmer Biomet) Fibergraft Bioactive Glass Allograft FM-02 Formagraft Cymbicyte Gamma-BSM GenerOs GranOS Globus Matrix ceramic Globus Medical conduct Globus NuBone Graston H-Genin Healos Bone Graft Replacement Healos Sponge HydroSet i-Factor Peptide Enhanced Bone Graft Inductaputty (hydroxapatite) InQu Integra Mozaik beta tricalcium phosphate (experimental for indications other than spinal fusion) Interface allograft InterGro DBM Plus Kainos+Nano Kinex Bioactive Putty Life Net AVS MAP3 Mastergraft allograft Mastergraft Granules Mastergraft Putty Mastergraft Strip Matrix Ovation Stem Cell Mesenchymal Stem Cell Therapy Mozaik allograft Nanoss bioactive bone void filler NextGraft NEXoss Norian SRS Norian SRS Fast Set Putty Novabone NovaBone bioactive strip NovaBone-C/M Nucell OpteMx Optimesh Orthospine Allostem or Osteostem Osiris Stryker Bio4 OsSatura TCP OsteoBlast II Osteocel Osteocel Plus Osteomatrix OsteoVation QWIK Osiris Therapeutics Ovation Ovation OS PalinGen PerioGlas Pioneer FortrOss PlatForm CM Plexus M Plexus P PolyGraft Porcine Intestinal Submucosa Surgical Mesh Pro Osteon Porous Hydroxyapatite Bone Graft SubstitutePurBone PurGEN Regeneration BioSet Regenexx PL-Disc Signafuse Bioactive Bone Graft Skaffold NMX Skaffold ReNu Flow SKYE Liquid Gel Spineology Optimesh Stryker Biotech OP-1 TriCore Trinity Elite Trinity Evolution Tripore TRS PCL Cranial Bone Void Filler TruFit bone plugs TruFUSE allograft bone dowel (miniSURG Corp.) TruRepair Venado Granules Viagraf Vitoss BA2X Wright Cancello-Pure Wright Cellplex Wright MIIGX3 Wright Pro-Dense Wright Pro-Stim.. Table: CPT Codes / HCPCS Codes / ICD-10 Codes 0565TAutologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation0566T injection of cellular implant into knee joint including ultrasound guidance, unilateral20690 - 20694Uniplane and multiplane fixation systems20900Bone graft, any donor area; minor or small (e.g., dowel or button)20902 major or large20955Bone graft with microvascular anastomosis; fibula20962 other than fibula, iliac crest, or metatarsal20974Electrical stimulation to aid bone healing, noninvasive (nonoperative)20975 invasive (operative)20979Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)22548 - 22819Arthrodesis, spine [spinal fusion]22853Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)22854Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)22859Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)27301 - 27499Femur (thigh region) and knee joint surgery29065 - 29085Application cast; upper extremity 29305 - 29355Lower extremity casts77072Bone age studies Opteform DBM, Bio DBM, Bioset, Propel DBM, Allosource femoral head bone graft, Optium allograft, Beta tri-calcium phosphate (b-TCP), AttraX Putty, Prime DBM HD, Kore Fiber, InterGro DBM, OsteoAMP, OsteoAMP Select and OsteoSelect – no specific code AlloStem; Arthrex biopaste (BioCartilage); ChronOS bone graft substitute, Cortiva Acellular Dermal Matrix, Acell biologic graft, BioD Restore, EmCell, kartogenin-treated autologous tendon graft, nacre (mother-of-pearl), Osteofuse, Rybone, SureFuse, SXBarrier (Surgilogix), Vivex Via graft (Amendia), Trufuse , Bioglass (45S5), Genetically corrected autologous epideral grafts, I-factor peptide enhanced bone graft, OsteoVive and synthetic bone graft, Intergro DBM Fibers, LifeNet Optium DBM, OsteoAMP, Vivigen, Osteomatrix or Arthrex Quickset (calcium phosphate cement), OsteoAMP, Avive tendon wrap, CartiMax allograft, Cerament bone void filler, collagen-based bio-inductive implants, Celling Biosciences Solum IV allograft, Equivabone Graft, Healos Bone Graft Replacement and Healos Sponge - no specific codeC1763Connective tissue, non-human (includes synthetic)E0747Osteogenesis stimulator, electrical, noninvasive, other than spinal applicationsE0749Osteogenesis stimulator, electrical, surgically implanted Q4001 - Q4048Casting supplies22548 - 22819Arthrodesis, spine [spinal fusion]Numerous optionsSubsequent encounter for fracture with nonunion, clavicle [Codes not listed due to expanded specificity]Numerous optionsSubsequent encounter for fracture with nonunion, humerus [Codes not listed due to expanded specificity] Numerous optionsSubsequent encounter for fracture with nonunion, ulna and radius [Codes not listed due to expanded specificity] Numerous optionsSubsequent encounter for fracture with nonunion, metacarpal bone(s) [Codes not listed due to expanded specificity] Numerous optionsSubsequent encounter for fracture with nonunion, femur [Codes not listed due to expanded specificity] Numerous optionsSubsequent encounter for fracture with nonunion, tibia and fibula [Codes not listed due to expanded specificity]Numerous optionsSubsequent encounter for fracture with nonunion, metatarsal bone(s) [Codes not listed due to expanded specificity]Numerous optionsSubluxation and dislocation of vertebrae [Codes not listed due to expanded specificity]C41.2Malignant neoplasm of vertebral columnC41.4Malignant neoplasm of pelvic bones, sacrum and coccyx C70.1Malignant neoplasm of spinal meningesC79.31Secondary malignant neoplasm of brainC79.32Secondary malignant neoplasm of cerebral meningesC79.49Secondary malignant neoplasm of other parts of nervous system C79.51 - C79.52Secondary malignant neoplasm of bone and bone marrowD16.8Benign neoplasm of pelvic bones, sacrum and coccyx D32.1Benign neoplasm of spinal meningesD33.4Benign neoplasm of spinal cordD42.0 - D42.9Neoplasm of uncertain behavior of meningesD43.0 - D43.2Neoplasm of uncertain behavior of brainD43.4Neoplasm of uncertain behavior of spinal cordD48.0Neoplasm of uncertain behavior of bone and articular cartilageG06.1Intraspinal abscess and granulomaM40.00 - M40.37, M40.50 - M40.57Kyphosis and lordosisM41.00 - M41.35, M41.80 - M41.9ScoliosisM43.00 - M43.19Spondylolysis and spondylolisthesisM46.20 - M46.28Osteomyelitis of vertebraM46.30 - M46.39Infection of intervertebral disc (pyogenic)M48.061 - M48.07Spinal stenosis, lumbar and lumbosacral regionM48.50x+ - M48.58x+Collapsed vertebra, not elsewhere classifiedM80.08x+ Age-related osteoporosis with current pathological fracture, vertebra(e)M84.48x+, M84.58+, M84.68+Pathological fracture [vertebrae]M86.18, M86.28, M86.68Acute, subacute and other chronic osteomyelitis [spinal]M89.68Osteopathy after poliomyelitis, other site [spinal]M90.88Osteopathy in diseases classified elsewhere, other site [spinal]M96.0Pseudarthrosis after fusion or arthrodesisM96.2 - M96.3Postradiation and postlaminectomy kyphosisM96.5Postradiation scoliosisM99.10 - M99.15Subluxation complex (vertebral)Q76.2Congenital spondylolisthesisS12.000+ - S12.9xx+ [S14.101+ - S14.159+ also required]Fracture of cervical vertebra with cervical spinal cord injuryS22.000+ - S22.089+ [S24.101+ - S24.159+ also required]Fracture of thoracic vertebra with thoracic spinal cord injuryS31.000+ - S31.001+Open wound of lower back and pelvisS32.000+ - S32.2xx+ [S34.101+ - S34.139+, S34.3xx+ also required]Fracture of lumbar vertebra, sacrum and coccyx with injury of lumbar and sacral spinal cord and cauda equinaS33.100+ - S33.141+Subluxation and dislocation of lumbar vertebraZ98.1Arthrodesis status [nonunion of prior fusion]M43.20 – M43.28Spinal fusionO09.00 - O09.93Supervision of high risk pregnancyO10.011 - O21.9, O23.00 - O26.43, O26.611 - O26.839, O26.86, O26.891 - O26.93, O29.011 - O29.93, O31.00x0 - O31.03x9, O35.7xx0 - O35.7xx9, O36.80x0 - O36.80x9, O36.821+ - O36.829+, O44.00 - O60.23x+, O67.0 - O67.9, O86.11, O86.13 - O86.29, O90.5 - O90.81, O98.011 - O99.03, O99.280 - O99.325, O99.340 - O99.345, O99.511 - O99.835, O9A.111 - O9A.53Maternal disorders predominantly related to pregnancy and childbirthQ81.2Epidermolysis bullosa dystrophicaZ34.00 - Z34.93Encounter for supervision of normal pregnancyZ39.0 - Z39.2Encounter for maternal postpartum care and examinationZ85.00 - Z85.71, Z85.79 - Z85.9Personal history of malignant neoplasmNumerous optionsOpen fracture of shaft of tibia [for skeletally mature persons stabilized with intramedullary nail fixation after appropriate wound management and applied within 14 days after the initial fracture] [Codes not listed due to expanded specificity]M43.25 - M43.27Fusion of lumbar spineM51.36 - M51.37Other lumbar and lumbosacral intervertebral disc degenerationNumerous optionsNonunion of fracture [Codes not listed due to expanded specificity] Numerous optionsSubluxation and dislocation of vertebrae [Codes not listed due to expanded specificity]C40.00 - C40.02Malignant neoplasm of scapula and long bones of upper limbC40.20 - C40.22Malignant neoplasm of long bones of lower limbC79.51 - C79.52Secondary malignant neoplasm of bone and bone marrowD16.00 - D16.02Benign neoplasm of scapula and long bones of upper limbD16.20 - D16.22Benign neoplasm of long bones of lower limbK60.3, K60.5Anal and anorectal fistulaM40.00 - M41.9Kyphosis, lordosis and scoliosisM43.00 - M43.19, M43.8X1 - M43.9Other deforming dorsopathiesM50.00 - M50.03Cervical disc disorder with myelopathyM50.30 - M50.33Other cervical disc degenerationM51.04 - M51.07Thoracic, thoracolumbar and lumbosacral intervertebral disc disorders with myelopathyM51.34 - M51.37Other thoracic, thoracolumbar and lumbosacral intervertebral disc degenerationM51.9Unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorderM85.00 - M85.09Fibrous dysplasia (monostotic)M85.40 - M85.69Solitary bone cyst, aneurysmal bone cyst and other cyst of boneM96.1 - M96.5Postprocedural complications and disorders of musculoskeletal system, not elsewhere classifiedM99.10 - M99.15Subluxation complex (vertebral)Q67.5Congenital deformity of spineQ76.2Congenital spondylolisthesisQ76.3Congenital scoliosis due to congenital bony malformationQ76.411 - Q76.49Other congenital malformations of spine, not associated with scoliosisS12.000+ - S12.9xx+ [S14.101+ - S14.159+ also required]Fracture of cervical vertebra with cervical spinal cord injuryS22.000+ - S22.089+ [S24.101+ - S24.159+ also required]Fracture of thoracic vertebra with thoracic spinal cord injuryS32.000+ - S32.2xx+ [S34.101+ - S34.139+, S34.3xx+ also required]Fracture of lumbar vertebra, sacrum and coccyx with injury of lumbar and sacral spinal cord and cauda equinaS42.451A, S42.452A, S42.453A, S42.454A, S42.455A, S42.456A, S42.461A, S42.462A, S42.463A, S42.464A, S42.465A, S42.466AClosed fracture of lateral and medial condyle of humerus S49.101A, S49.102A, S49.109A, S49.111A, S49.112A, S49.119A, S49.121A, S49.122A, S49.129A, S49.131A, S49.132A, S49.139A, S49.141A, S49.142A, S49.149A, S49.191A, S49.192A, S49.199AClosed physeal fracture of lower end of humerus S52.601A, S52.602A, S52.609A, S52.611A, S52.612A, S52.613A, S52.614A, S52.615A, S52.616A, S52.691A, S52.692A, S52.699AClosed fracture of lower end of ulna S59.001A, S59.002A, S59.009A, S59.011A, S59.012A, S59.019A, S59.021A, S59.022A, S59.029A, S59.031A, S59.032A, S59.039A, S59.041A, S59.042A, S59.049A, S59.091A, S59.092A, S59.099AClosed physeal fracture of lower end of ulnaS72.021A - S72.021C, S72.022A - S72.022C, S72.023A - S72.023C, S72.024A - S72.024C, S72.025A - S72.025C, S72.026A - S72.026CFracture of epiphysis (separation) (upper) of femur S72.441A, S72.442A, S72.443A, S72.444A, S72.445A, S72.446AClosed fracture of lower epiphysis (separation) of femur S79.001A, S79.002A, S79.009A, S79.011A, S79.012A, S79.019A, S79.091A, S79.092A, S79.099AClosed physeal fracture of upper end of femurS79.101A, S79.102A, S79.109A, S79.111A, S79.112A, S79.119A, S79.121A, S79.122A, S79.129A, S79.131A, S79.132A, S79.139A, S79.141A, S79.142A, S79.149A, S79.191A, S79.192A, S79.199A Closed physeal fracture of lower end of femur0232TInjection(s), platelet rich plasma, any tissue, including image guidance, harvesting and preparation when performed0481TInjection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performedP9020Platelet rich plasma, each unitS9055Procuren or other growth factor preparation to promote wound healingP9022Red blood cells, washed, each unitD47.3Essential (hemorrhagic) thrombocythemiaD69.41 - D69.6Other primary and secondary thrombocytopenia46707Repair of anorectal fistula with plug (e.g., porcine small intestine submucosa [SIS])20930Allograft for spine surgery only; morselized20931Allograft for spine surgery only; structuralC1762Connective tissue, human (includes fascia lata)M43.20 - M43.28Fusion of spineC9359Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Putty, Integra OS Osteoconductive Scaffold Putty), per 0.5 ccC9362Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Strip), per 0.5 ccM43.20 - M43.28Fusion of spineNumerous optionsDelayed healing of fracture [Codes not listed due to expanded specificity] 7th character G [when structural integrity is required, subsequent encounter for fracture with delayed healing]Numerous optionsMalunion of fracture [Codes not listed due to expanded specificity] 7th character K [when structural integrity is required, covered as an adjunct to approved biologic or non-biologic implants]Numerous optionsNonunion of fracture [Codes not listed due to expanded specificity] 7th character P0707TInjection(s), bone substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization11981Insertion, non-biodegradable drug delivery implant11982Removal, non-biodegradable drug delivery implant11983Removal with reinsertion, non-biodegradable drug delivery implant+20700Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure)+20701Removal of drug-delivery device(s), deep (eg, subfascial) (List separately in addition to code for primary procedure)+20702Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure)M86.30 – M86.69Chronic osteomyelitis [PMMA antibiotic beads are covered when used with IV antibiotics in the treatment of chronic osteomyelitis]38232Bone marrow harvesting for transplantation; autologous 38240 - 38241Hematopoietic progenitor cell (HPC) transplantation20615Aspiration and injection for treatment of bone cyst20939Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure) 22548 - 22819Arthrodesis, spineS2142Cord blood-derived stem-cell transplantation, allogeneicS2150Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre- and post-transplant care in the global definitionC00 - D49.9NeoplasmsD50.0 - D89.9 Diseases of the Blood and Blood-forming organs and certain disorders involving the immune mechanismM85.40 - M85.69Cyst of boneNumerous optionsMalunion of fractures [Codes not listed due to expanded specificity] Numerous optionsNonunion of fracture [Codes not listed due to expanded specificity] M93.20 - M93.29Osteochondritis dissecansM96.0Pseudarthrosis after fusion or arthrodesisZ98.1Arthrodesis statusNo specific codeQ4116Alloderm, per square centimeterQ4173Palingen or palingen xplus, per square centimeterQ4174Palingen or promatrx, 0.36 mg per 0.25 ccQ4195 - Q4197PuraplyC9356Tendon, porous matrix of cross-linked collagen and glycosaminoglycan matrix (Tenoglide Tendon Protector Sheet), per square centimeter [Tendon Wrap Tendon Protector]22548 - 22819 Arthrodesis, spine [spinal fusion]C9359Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Putty, Integra OS Osteoconductive Scaffold Putty), per 0.5 cc C9362Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Strip), per 0.5 cc M86.9Osteomyelitis, unspecified0547TBone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score0707TInjection(s), bone-substitute material (eg, calcium phosphate) into subchondral bone defect (ie, bone marrow lesion, bone bruise, stress injury, microtrabecular fracture), including imaging guidance and arthroscopic assistance for joint visualization Abjornson C, Brecevich A, Callanan T, et al. ISASS recommendations and coverage criteria for bone graft substitutes used in spinal surgery.

The psoas muscle may be the most important muscle in your body. Read on to find out whether you might have a psoas muscle imbalance, and how to correct it.

The. types of movement that can strain your psoas muscles include standing and twisting. from your waist without moving your feet (think old-fashioned calisthenics) or any. movement that causes your leg to externally rotate while extended, such as ballet-style. leg lifts (or battement ), and even doing too many sit-ups (your psoas muscles complete the. last half of a sit-up).. Also, the diaphragm and the psoas muscles are connected. through fascia that also connects the other hip muscles.. When you have. a tight (or short) psoas muscle, you may experience pain in your lower back or in. your hips, especially when lifting your legs.. While most. people with psoas issues have tight psoas muscles, there are some people whose psoas. muscles can be overstretched.. When your psoas is too short or tight , it can pull your pelvis into an anterior tilt, compressing the spine and pulling your back into hyperlordosis or “duck butt.” If your psoas is overstretched or weak , it can flatten the natural curve of your lumbar spine, creating a “flat butt.” This misalignment is characterized by tight hamstrings pulling down on the sitting bones, which cause the sacrum to lose its natural curve and result in a flattened lumbar spine.. The best. part is you can learn how to do somatic movements at home to help ease the pain. of tight muscles, including your psoas muscles.. While. most people with psoas imbalances will be able to heal through the exercises I mention. above, there are some people who suffer from psoas syndrome , a painful condition. often misdiagnosed because the symptoms are difficult to distinguish from other. causes of back and hip pain.

Videos

1. How To Fix Sway Back Posture | The ULTIMATE Guide
(GuerrillaZen Fitness)
2. Best Back Brace VENUM™ 1 TLSO w/ ATE Fitting Instructions
(OPTEC USA)
3. Modvel Back Brace
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4. THUASNE LombaFirst Spinal Back Brace fitting instructions
(Thuasne UK)
5. Neo G Back Brace with Power Straps // How to Apply Guide
(Neo G)
6. How to Choose a Knee Brace for Arthritis or Knee Pain| GUIDE
(Dr. Michael Tang PT, DPT, CSCS)

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