Spinal bracing utilizes these primary objectives:
- Controlling back pain by limiting motion and unloading discs, vertebrae and other spinal structures by compressing the abdomen.
- Stabilizing weak or injured structures by immobilizing the spine.
- Providing three-point force systems to provide correction or prevent progression of a deformity.
The segment of the body that is being controlled generally classifies spinal bracing terminology.
- Sacroiliac (SIO)
- Lumbosacral (LSO)
- Thoracolumbosacral (TLSO)
- Cervicothoracolumbosacral (CTLSO)
- Cervicothoracic (CTO) orthoses. Control is described in terms of spinal flexion, extension, rotation and lateral bending.
- Cervical (CO)
Spinal orthoses are categorized as flexible, rigid or semi-rigid.
Flexible orthoses or corsets are prescribed for relief of low back pain associated with degenerative disc disorders, trauma, or postural deformities. Corsets are typically made of cotton and nylon materials. Corsets are used to de-weight spinal structures by increasing abdominal compression. Rigid stays and inserts can be added to restrict motion and act as a postural reminder. Most corsets are pre-fabricated and custom fit and modified to the patient’s specific needs.
Rigid orthoses are commonly custom fabricated and provide the most support to the area being treated. A body jacket or TLSO controls motion in all planes. Depending on the goals of the TLSO, design can be modified accordingly. A two piece front and back design is commonly used post operatively for ease of application while a front or back opening single piece design is commonly utilized when treating scoliosis. Velcro™ straps are most commonly used to fasten the closure on all orthoses today.
When indicated, orthotic management of the spine can be very successful. When orthotic care is needed, it is important that the health care professional providing these services is properly credentialed.
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