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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
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Sagittal control LSO
- decrease gross/intersegmental trunk flexion/extension
- kinesthetic reminder
- 3 point system
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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
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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
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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
 
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Extension-coronal control LSO
- prevent lateral flexion and extension
- dynamic orthosis (allow some trunk flexion)
- Indication
- ----treat spondylolisthesis
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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
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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
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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
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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
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Thermoplastic spinal orthoses
- encase trunk
- immobilize spine in all 3 planes of motion
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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
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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
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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
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