Spinal Bracing: A Treatment Option for Spondylolisthesis
With spondylolisthesis, it may be more difficult for your spine to provide proper support because the vertebrae are out of alignment. That can make your muscles work harder, which fatigues them and can lead to pain. To support your lower back, your doctor may want you to wear a brace or a corset for awhile.
Children or adults with spondylolisthesis can wear braces or corsets as part of a non-surgical (or conservative care) treatment plan. Bracing is usually recommended for patients with a pars interarticularis fracture that is likely to heal—if given the right support.
A lumbar brace or corset will compress your abdomen, and that will take some of the pressure off your spinal column. The goal is to give you some pain relief while keeping your spine safe as the pars interarticularis fracture tries to heal.
Corsets are made of a soft fabric, and they usually have sturdy supports—stays—in them. Like corsets that women used to wear, medical corsets also lace up, either from the front, back, or side. Most likely, you'll have to wear your corset during the day, but you'll be able to take it off at night. Your doctor, though, will give specific instructions on how and when to wear it.
Braces are made of plastic, so they're more rigid than corsets. There are many types of braces available today, such as the Boston brace, and your doctor will figure out which brace is best for you.
You may even need to have a brace custom made, especially if you have very severe spondylolisthesis (the vertebra has slipped forward quite far over the one below it). Custom-made braces are made by an orthotist, and your doctor will recommend one for you. You'll need to see him or her for the fitting.
Wearing a Corset or Brace
For the corset or brace to be effective, you have to adhere to all of your doctor's instructions. When you first get the corset or brace, he or she will tell you when to wear it, how to wear it, and what to avoid doing while wearing it. The doctor (or other medical professional—perhaps a nurse) will even explain what to do to avoid skin irritation. A general hint is to wear a light cotton T-shirt under the brace to protect your skin.
You may be concerned that wearing a brace will cause your back muscles to weaken too much. Don't worry about that—most doctors don't believe that to be the case. If you follow the doctor's directions about when to wear the brace (and don't wear it more than you are told to), then your body shouldn't become overly dependent on it.
Bracing after Surgery
If you have to have surgery to fix or stabilize your spondylolisthesis, you may need to wear a brace after the surgery. This will help support your spine and muscles while you heal.