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

Bracing is a common modality in treating spinal fractures. Its objective is to reduce spinal movements and to stabilize the fracture. Until now, factu al insight into the movement-reducing properties of Thoraco-Lumbar-Sacral O rthoses (TLSOs) has been missing. Two common TLSOs (e.g., Jewett and Voigt- Bahler) were tested for their movement-reducing properties in two small gro ups of healthy subjects. In the first study, maximal gross spinal movements , with and without a TLSO, were measured by means of a Portable Posture Reg istration Set (PPRS) in three different planes. In the second study, maxima l 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 PPR S and X-ray techniques, significantly reduced the segmental as well as gros s spinal movements. However, the amount of movement reduction varied greatl y from subject-to-subject and was sometimes small. Unfortunately, data are lacking on the amount of movement reduction that is clinically relevant.