OandP 2

  1. Types of traditional spinal orthoses
    • 1. Sagittal control LSO
    • 2. Sagittal-coronal LSO
    • 3. Extension-coronal control LSO
    • 4. Flexion-coronal control LSO
    • 5. Sagittal control TLSO
    • 6. Sagittal-coronal control TLSO
    • 7. Triplanar control TLSO
  2. Sagittal control LSO
    • decrease gross/intersegmental trunk flexion/extension
    • kinesthetic reminder
    • 3 point system
    • Image Upload 1
  3. Sagittal control LSO Indications
    • LBP
    • lumbar sprain/strain
    • lumbar disc displacement
    • osteoporosis
    • HNP
    • post-op laminectomy
    • post-op discectomy
    • spondylolisthesis
    • post-op fusion
    • spinal stenosis
  4. Chairback LSO
    • sagittal control LSO
    • treat LBP by decreasing gross and intersegmental trunk flexion/extension
    • kinesthetic reminder
    • does not exert sufficient control to stabilize trunk after spinal fracture
    • Indications: LBP, lumbar sprain/strain, lumbar disc displacement, osteoporosis, HNP, post-op laminectomy, post-op discectomy, spondylolisthesis, post-op fusion, spinal stenosis
    • different styles, traditional design uses thoracic and pelvic band connected by 2 paraspinal bars
    • can be made into a TLSO by extending proximal length of paraspinal bars and adding shoulder straps
    • utilizes 3 point force system
    • ----stops forward flexion by 2 posterior directed forces at xiphoid and pubis levels opposed by single anterior directed force mid-point of paraspinal bars
    • ----stops extension by 2 anterior directed forces of thoracic and pelvic bands opposed by single posterior directed force mid-point of corset panel
  5. Sagittal-coronal LSO
    • thoracic and pelvic bands connected by paraspinal and lateral bars
    • flex/ext, and lateral flexion controlled by 3 point system
    • comes up a bit higher than sagittal LSO
    • Indication:
    • ----stable non-compression fx of L-spine
    • Image Upload 2Image Upload 3
  6. Extension-coronal control LSO
    • prevent lateral flexion and extension
    • dynamic orthosis (allow some trunk flexion)
    • Indication
    • ----treat spondylolisthesis
    • Image Upload 4
  7. Flexion control TLSO
    • limit trunk flexion and encourage trunk hyperextension
    • 3 pt system: posterior directed forces at sternum and pubis opposed by anterior directed force at posterior lumbar pad
    • Indications
    • ----compression fx L-spine and lower T-spine
    • Image Upload 5
  8. Sagittal control TLSO
    • limit trunk flexion and extension in T-spine and L-spine
    • pelvic band, 2 paraspinal bars, interscapular band, pair of axillary straps
    • limit trunk flexion via posterior directed force at axillary straps
    • limit trunk extension via anterior directed force at interscapular band
    • Indication
    • ----compression fx
  9. Sagittal-coronal control TLSO
    • resists trunk extension, flexion and lateral flexion at T-spine and L-spine
    • pelvic band, thoracic band, lateral bars, paraspinal bars reaching spine of scapula, interscapular band, pair of axillary straps
    • treat: spondylolisthesis, spinal stenosis, HNP, disc infection, post-op fx
    • Image Upload 6
  10. Triplanar control TLSO
    • limit trunk rotation, flexion and extension (controls all motions!!)
    • pelvic band, sidebars, paraspinal bars, thoracic band, set of subclavicular extensions that wrap around anterior trunk from thoracic band
    • a.k.a. Cowhorn Orthosis (bc have subclavicular protections)
    • treat: post-op surgical repair of fx or spinal deformity of T-spine and/or upper L-spine
    • Image Upload 7
  11. Thermoplastic spinal orthoses
    • encase trunk
    • immobilize spine in all 3 planes of motion
  12. Thermoplastic spinal orthoses trimlines
    • superior LSO trimline: superior to xiphoid process
    • superior TLSO trimline: sternal notch
    • inferior LSO/TLSO trimline: shaped to envelop pelvis and anteriorly end at groin
  13. Thermoplastic spinal orthoses Treatment indications
    • instability or dysfunction at several vertebral levels
    • significant instability after burst fx
    • post-op care with traumatic vertebral fx or SCI
    • spinal deformity s/p fusion
    • s/p instrumental surgery at thoracolumbar level
    • requires custom fit
  14. Types of thermoplastic spinal orthoses
    • 1. Boston overlap brace
    • 2. Custom Molded TLSO
    • 3. soft collar
    • 4. Reinforced cervical collar (Philly, Miami J, Aspen)
    • 5. Cervical thoracic orthoses (CTO)
    • 6. Yale CTO
    • 7. Minervia CTO
    • 8. Sterno-occipito-mandibular immobilizer (SOMI)
    • 9. Halo
Card Set
OandP 2
OandP 2