OandP 1

  1. Functions of spinal orthoses
    • 1. Immobilize gross spinal motions
    • 2. Immobilize individual motion segments
    • 3. Apply external forces to correct deformity or prevent progression of deformity
  2. Treatment goals of spinal orthoses
    • 1. Control motion of trunk, especially after surgery
    • 2. Support abdomen or spine
    • 3. Manage pain to improve function
  3. Treatment goal of Low back pain (LBP)
    • 1. limit L/S motion
    • 2. increase abdominal support
    • 3. decrease pain
  4. Tx goal and primary function of Orthotics for treatment of spinal fx
    • Treatment goal:
    • ----Limit gross motion of trunk to decrease movement and sway of vertebral column during ADLs/functional mobility
    • Primary function:
    • ----provide biomechanical stability through
    • 1. limit trunk flexion/extension/rotation/lateral flexion
    • 2. reduce segmental motion of spine
    • 3. position spine in hyperextension using 3 point system to permit optimal bone healing
    • no prone for vertebral fx
  5. Management of Thoracolumbar Fracture without signs of neurologic compromise
    • orthosis effective alone by holding trunk in sagittal hyperextension
    • for:
    • ----1. fx 2’ lap/seat belt injury
    • ----2. flexion distraction injury
    • ----3. moderate-severe wedge compression fracture
    • ----4. burst fracture
  6. Management of Complex and unstable thoracolumbar fracture
    • surgical intervention
    • post-op immobilization by custom TLSO in neutral sagittal alignment
  7. Thoracic trimline levels
    anterior height to resist forward flexion at sternum
  8. Thoracic and Lumbar trimline levels
    extend into groin to capture pelvis firmly
  9. Cervical trimline components
    can be added to TLSO (prox to T5) to stabilize upper T-spine and C-spine
  10. Orthotic hip joint trimline
    • can be added to LSO and TLSO to immobilize LS joint
    • (L4-S1)
  11. Sacroiliac (SI) belt (trimlines)
    • SI belt trimlines
    • ----inferior to waist
    • ----superior to pubis
    • Image Upload 1
  12. Lumbosacral (LS) corset (function, tx goals, trimlines)
    • Function of LS corset
    • ----Encompass abdomen & pelvis
    • ----Increase intra-abdominal pressure
    • ----Exert circumferential pressure
    • ----Transmit 3 point pressure system to the l- spine
    • Treatment goals:
    • ----decrease lumbar lordosis and increase intra-abdominal cavity pressure
    • ----Increase lumbar lordosis to open intervertebral space
    • LS corset trimlines
    • ----Anterior border:
    • --------superior to pubic symphysis
    • --------inferior to xiphoid process
    • ----Posterior border
    • --------superior to sacrococcygeal junction
    • --------inferior to inferior angle of scapula
    • Image Upload 2Image Upload 3
  13. Thoracolumbar corset (dorsolumbar) (info and trimlines)
    • Same thing as LS corset but increased leverage to control motion and support trunk
    • Doesn’t have good enough lever to prevent intersegmental thoracic spinal motion
    • Kinesthetic reminder
    • Thoracolumbar corset trimlines
    • ----inferior border: sacrococcygeal junction
    • ----superior border: inferior to spine of scapula
    • Image Upload 4
  14. Traditional spinal orthoses (info)
    • provide motion control and trunk support
    • pelvic and thoracic band wrap around laterally and end at midaxillary trochanteric line (MATL)
    • set of paraspinal and/or lateral bars
    • Image Upload 5
Card Set
OandP 1
OandP 1