![]() ![]() No specific criteria are available for determining when or which orthosis is indicated.Spinal orthoses should be prescribed judiciously, typically in conjunction with a rehabilitation treatment program fostering patient independence and minimizing the potential of their adverse effects.As their main purpose is to immobilize and support the spine, it is important to remember that orthoses may interfere with mobility and activities of daily living.Literature suggests to best immobilize the L4-L5 and L5-S1 levels, a unilateral thigh extension is required on a rigid lumbosacral orthosis.The Philadelphia or similar cervical orthosis requires a thoracic extension for controlling C6-T5 (cervicothoracic junction).The halo achieves the best control, but “snaking”, or movement, in the cervical spine still occurs.No spinal orthosis achieves complete immobilization of the spine.Spinal orthoses relieve symptoms that accompany postural deviation by moving a patient’s spine and trunk into the best possible alignment.While there may be a potential to regulate adolescents’ spinal growth, the goal of adult bracing is to apply external forces to the spine and trunk to temporarily improve spinal alignment.Adult spines are more rigid than pediatric spines and are less responsive to external forces.While they use similar materials, the proposed mechanism of action is different.There are differences between spinal orthoses for pediatric and adult populations.Skin irritation or even ulceration may occur diligence in fitting and monitoring is essential. ![]()
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