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Spinal Bracing
David Falk, CPO
Falk Prosthetics & Orthotics, Inc
Delray Beach, Florida |
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Orthotic management of spinal
disorders dates back at least to the Middle Ages. Some of the
concepts underlying those primitive devices, notably three-point
forces, remain valid today. Fabrication materials have progressed
from metal and leather to light weight thermoplastics allowing
many new designs and a new level of comfort for the patient.
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), cervical (CO) and cervicothoracic
(CTO) orthoses. Control is described in terms of spinal flexion,
extension, rotation and lateral bending.
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 patients 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. An ABC certified orthotist
has the highest minimum credentials in this specialized field.
An ABC certified practitioner will use the prefix (CO) certified
orthotist or (CPO) certified prosthetist/orthotist next to their
name.
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LSO Corset |
Chairback Orthosis |
Knight Taylor Orthosis |
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Cash Extension Orthosis |
Jewett Extension Orthosis
Spika |
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TLSO Body Jacket |
TLSO Body Jacket |
LSO With Hip |
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