AN UPDATE ON ORTHOTIC DEVICES FOR THE LUMBAR SPINE BASED ON A REVIEW OF THE LITERATURE

Orthoses are often used to treat lumbar spine disorders, although thei r indications have rarely been evaluated in clinical trials. We review ed the literature for data on the effects of lumbar spine orthoses. Ap art from bermuda corsets, restriction of intervertebral mobility seems limited at the most distal levels (L4-L5 and L5-S1). Restriction of e xtreme gross spinal motions can be achieved and is more marked for lat eral bending than for forward bending or extension. Stiff corsets prov ide greater motion restriction than flexible corsets, although there a re wide interindividual variations. Stiff orthoses are associated with decreased intradiscal pressure and increased intraabdominal pressure. Studies of the electrical activity of trunk muscles have produced con flicting data as a result of marked interindividual variability. In mo st studies, use of orthotic devices did not induce muscle wasting. Alt hough lumbar spine orthoses are often prescribed with the goal of indu cing analgesic, proprioceptive and preventive effects in the workplace , whether such effects are actually obtained, has not been adequately evaluated. Based on our literature review we have drawn a list of the main indications for orthotic devices according to the desired effects in various disorders of the lumbar spine.