Vol. 37 No. 4, July/August 2000

Assessment of spinal movement reduction by thoraco-lumbar-sacral orthoses

Peter J. van Leeuwen, MD; Renate P. Bos, Msc; José C. Derksen, Msc; Jaap de Vries, PhD, MD

Rehabilitation Center "Blixembosch", Eindhoven, The Netherlands, Roessingh Research and Development, Rehabilitation Center "Het Roessingh", Enschede, The Netherlands, Department of Biomedical Physics and Technology, Faculty of Medicine and Allied Health Sciences, Erasmus University Rotterdam, The Netherlands

Abstract — Bracing is a common modality in treating spinal fractures. Its objective is to reduce spinal movements and to stabilize the fracture. Until now, factual insight into the movement-reducing properties of Thoraco-Lumbar-Sacral Orthoses (TLSOs) has been missing. Two common TLSOs (e.g., Jewett and Voigt-Bähler) were tested for their movement-reducing properties in two small groups of healthy subjects. In the first study, maximal gross spinal movements, with and without a TLSO, were measured by means of a Portable Posture Registration Set (PPRS) in three different planes. In the second study, maximal segmental vertebral movements in the regions T10 to L4 were measured via X-rays. With few notable exceptions, wearing a TLSO, as measured by the PPRS and X-ray techniques, significantly reduced the segmental as well as gross spinal movements. However, the amount of movement reduction varied greatly from subject-to-subject and was sometimes small. Unfortunately, data are lacking on the amount of movement reduction that is clinically relevant.

Key words: movement analysis, orthoses, spine, thoracolumbar fractures