Combo LSO Sacro-Form w/Elastic Front
[8121E]

HCPCS: L0633 or L0649
HCPCS review letter on file.

Combo LSO Sacro-Form Brace with Elastic Front. Similar to Model 8121, but with lightweight plastic (instead of aluminum frame) encased between soft foam liner and firm foam exterior. The Sacro-Form is also distinct in having an elastic front closure along with a 5" heavy elastic compression band. Both compression band and elastic front secure by hook 'n pile closure. Elastic front closure has plastic reinforcement. Sized according to hip measurement.

Back height: 12"

Sizes:
S (28"-32")
M (34"-38")
L (40"-44")
XL (46"-48")
2XL (50"-52")