SPINE ORTHOSIS

HATDOG FINAL TERM

Positive Effects of Orthotic Wear

(TMS)

Trunk Support

Motion Control

Spinal Realignment

Increases the intra-abdominal pressure (Trunk Support)

Increases the stability of the spine

Decrease the demand on Spinal Musculature (Trunk Support)

Lesser need for muscular activation on stabilizers, postural, and structural muscles

What Point control system does spinal orthoses use? (Motion Control)

3-point control system (Pressure and counterpressure applied on body segments)

Spinal Realignment

Alteration of weight-bearing mechanism to different parts of the torso

Negative Effects of Orthotic Wear

PAWT

Psychological Dependence

Aggravation of Symptom Patterns

Weakness and Atrophy following reduced Functional demands

Tightness/Contracture following Immobilization

Mostly elastic belts or Cloths (Corsets or Belts)

Flexible Spinal Orthoses

Where should be Sacroiliac belt located?

Between the Iliac Crest and Trochanters

It prevents the upward displacement of sacroiliac belt

Perineal Straps

What joint does SI Belt stabilizes?

Sacroiliac Joint

Uses of SI belt

Postpartum and Posttraumatic SI preparations

What substance does the body releases during pregnancy that makes the ligaments lax as preparation for delivery?

Relaxin

Cloth garment that encompasses the pelvis and has an adjustable in circumference by means of side, front, or back laces

Sacroiliac Corset

Anterior and Posterior Superior Border of SI Corset

Iliac Crest

Anterior Inferior border of SI Corset

1/2 - 1 inch above Pubic Symphysis

Posterior Inferior border of SI Corset

Apex of Gluteal bulge

Uses of SI corset

Assist in elevating IAP (Intraabdominal pressure)

SI Corset is used for:

Postpartum and posttraumatic stabilization of SI and Pubic symphysis joints

Fabric with elastic sections, wrapped around lumbar region with Velcro closure

Lumbar Binder

What is the positive effect of Lumbar Binder?

Trunk Support through Increase in Intraabdominal pressure

Lumbar Binder is used by:

Weightlifter and reminder of pts. of Proper Posture

Most Common used Flexible orthosis (Prefabricated) which encompasses the torso and the hips

Lumbosacral Corset

Anterior Superior border of LS Corset

1/2 inch below xiphoid process or Above lower ribs

Anterior Inferior Border of LS Corset

1/2 - 1 inch above Pubic Symphysis

Posterior Superior border of LS Corset

1 inch below Inferior angle of Scapula

Posterior Inferior border of LS Corset

Apex of Gluteal bulge (Men)

Gluteal fold (Women)

LS Corset is altered if:

WFD

Wrinkles

Failure to maintain position

Discomfort

Cloth garment that encompasses the torso and hips and has shoulder straps that encircle the axilla, cross posteriorly, and fasten anteriorly

Thoracolumbar Corset

Usually reinforced with posterior rigid / semirigid stays

Thoracolumbar Corset

Rigid material added to corsets for added Stability

Stays

Anterior Border of TL Corset

Same with Lumbosacral corset

AnteroSuperior border of TL Corset

Just below Costal Margin

PosteroSuperior border of TL Corset

Scapular Spines

PosteroInferior border of TL Corset

Apex of Gluteal bulge (Men), Gluteal Fold (Women)

Function of Thoracolumbar Corset

Trunk Stabilization

Elevates Intraabdominal Pressure

Reminder to restrict motion

What needs to be added if there’s a discomfort to the area of Axilla

Shoulder strap with Padding

Spinal Orthoses that uses metals or rigid materials

Rigid Spinal Orthoses

Posterior component of Rigid spinal orthoses

Band

Band but it continues to the front

Strap

Components of Rigid Spinal orthoses

PTCPLOIFC

Pelvic Band

Thoracic Band

Cowhorns

Posterior Uprights (Lumboscaral or Thoracolumbosacral)

Lateral Uprights

Oblique Lateral Uprights

Interscapular Band

Full-front Abduction Support

Corset Front

Lateral End of Pelvic Band

Between Greater trochanter and Iliac crest: Extend to mid trochanteric line

Function of Lateral End of Pelvic Band

Avoid impingement of bony prominences and provide attachment to pelvic strap

Posterior Border of Pelvic Band

Middle Section above Inferior edge of Sacrum and below PSIS

Superior Border of Thoracic Band

T9-T10, or 1 inch below inferior angle of Scapula

Lateral End of Thoracic Band

Lateral midlines of Rib Cage (Mid-Axilla lines)

Thoracic band is worn horizontally and continues anterior

Thoracic Strap

Anterior extensions of thoracic band with Subclavicular pads which extends horizontally forward, curving up around the Pectoralis Major

Cowhorns

Superior border of Cowhorns

1/2 inch below Clavicle

Lateral border of Cowhorns

Medial to Delto-Pectoral groove (To not interfere with arm motions but still provide maximum control)

2 inches in diametes and prevents pressure sores and usually connected yung left and right pads by a strap

Subclavicular Pads

Shorter Posterior Uprights

Longer Posterior Uprights

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Lumbosacral Posterior Uprights

Thoracolumbosacral Posterior Uprights

Superior end of LS Posterior Uprights

Superior edge of thoracic band (1 inch below the inferior angle of scapula)

Superior End of Thoracolumbosacral Posterior Uprights

Lateral aspect of Scapular spines

Inferior ends of LS and TLS Posterior Uprights

Inferior edge of pelvic band at its posterior midline

Spacing of Posterior Uprights

2 inches (Guide: Bulkiest portion of Spinal Muscles)

Superior border of Lateral uprights

Superior edge of Thoracic band (Same level of Lumbosacral Posterior Uprights)

Inferior Border of Lat Uprights

Inferior edge of Pelvic Band

It extends along the lateral midlines of torso (From mid trochanter to mid axilla)

Lateral Uprights

It is connected to Lateral Uprights

Oblique Lateral Uprights

Superior border of Oblique Lateral Uprights

Attached to Lateral Uprights (Approx. 1 inch below Inferior border of Thoracic Band)

Inferior border of Oblique Lateral Uprights

Rigidly attached to Pelvic Band at the Posterolateral section

Located between two Scapula and crosses distal 1/3 of Scapulae

Interscapular Band

Inferior edge of Interscapular Band

1 inch above Inferior angles of Scapulae

Looks like apron

Full-Front Abduction Support

Superior Border of F-F ABD Support

1/2 inch below xiphoid process

Inferior border of F-F Abduction Support

1/2 inch above Symphysis Pubis

Lateral Border of F-F ABD Support

Lateral midlines or Lateral Uprights

Attached to Pelvic band: Passes inferior to ASIS: Approx. 1 inch above Inferior border

Pelvic Strap

Loop around Posterior Uprights: Between Iliac crest and rib cage

Waist Strap

Attached to Thoracic Band or Posterior Uprights: Attached to Superior Border of Apron

Thoracic Strap

To avoid wrinkling of Abdominal support if patient if tall

Additional Strap

It is same with full-front abdominal support in size, biomechanical function, and trim lines

Corset Front

Difference between Corset Front and F-F ABD Support

Corset front is attached to Lateral Uprights by Laces

Posterior attachment of LS F-E Control Orthosis (Chairback)

2 LS Post Uprights attached to a Pelvic Band and a Thoracic Band

Anterior attachment of LS F-E Control Orthosis (CHAIRBACK)

Full-Frontal Abdominal fastened to a Post Uprights by Straps

Functions of Chairback

Restricts Flexion and Extension

Posterior force when restricting Flexion (Chairback)

Pelvic and Thoracic straps

Anterior force when restricting Extension (Chairback)

Posterior Uprights

Posterior force when restricting Extension: (Chairback)

Abdominal support

Anterior force when restricting Extension (Chairback)

Pelvic and Thoracic bands

T OR F: Corsets can be worn over orthosis in place of Full-frontal Abdominal Support

True

It is same with chairback but with Additional Lateral Uprights

LS F-E-L Control Orthosis (KNIGHT)

Functions of Knight

Restricts Flexion and Extension with Lateral Motions (D/t Lateral Uprights)

T OR F: Lateral Bands must be fitted carefully over Iliac crest to avoid Pressure

F - Lateral Uprights

Orthosis when Pelvic and Thoracic bands joined by a pair of Lateral Uprights

LS E-L Control Orthosis (WILLIAMS)

What stabilizes Pelvic Band in Williams Orthosis?

Oblique Lateral Uprights

Functions of WILLIAMS Orthosis

Restricts Extension and Lateral Motion

Posterior force when restricting Extension (Williams)

Abdominal Support

Anterior force when restricting Extension (Williams)

Pelvic and Thoracic bands

Medial force when restricting Lateral Motion (Williams)

Ends of Pelvic and Thoracic Bands

Composed of 2 TLS Post Uprights attached inferiorly to a Pelvic Band

TLS F-E Control Orthosis (Taylor)

It stabilizes the Upright and serves as an Attachment for Axillary Straps

Interscapular Band

It is a Corset or Full-Front Abdominal Support Anteriorly

Taylor Orthosis

Attached to superior ends of Uprights and extend anterior over the Shoulder, then pass under Axillae to buckle at Interscapular band

Axillary Straps

Functions of Taylor

Restricts Flexion and Extension

It is same with Taylor but with Additional Lateral Uprights

TLS F-E-L Control Orthosis (Knight-Taylor)

Functions of Knight-Taylor

Restricts Flexion-Extension, and Lateral Motion

Its Pelvic and Thoracic bands are connected by a pair of LS Post uprights ad a pair of Lateral Uprights

TLS F-L-R Control Orthosis (Cowhorn)

T or F: Abdominal support is laced on lateral uprights in Cowhorn Orthosis

True

Functions of Cowhorn Orthosis

Resists Flexion-Extension (Lumbar Only), Lateral Motion and Rotation