Cervical, Thoracic, and Lumbosacral Orthoses

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Condition: Cervical, thoracic, and lumbosacral orthoses are devices/braces that may help relieve pain caused by problems in the spine. They are also used to restrict movement in people with back/neck injuries or after spinal surgery. Orthoses are also used in children with scoliosis (crooked spine - too much of a curve or bend to one side) to prevent progression of curvature.     

Background: Problems in different parts of the spine – cervical (top – i.e. neck), thoracic (middle – i.e. chest level), and lumbosacral (lower – i.e. low back) – need different types of orthoses to keep the spine in the correct position and from moving too much. Some are soft and flexible while others are rigid.

Risk Factors: Orthoses may be less effective in overweight people. They can be especially uncomfortable to wear when it is hot and humid.

History and Symptoms: The doctor first needs to diagnose the problem and then decide if an orthosis is the right way to treat it.    

Diagnostic Process: X-rays are used to help diagnose problems in the spine. MRI and CT scans may also be used to help choose the best device. 

Rehab Management:  Orthoses are just one part of a rehab program for people with spinal problems.  A physical medicine and rehabilitation (PM&R) physician is uniquely trained and qualified to lead a multidisciplinary team and comprehensive approach to treatment of patients requiring orthoses.  A PM&R physician  can help determine the most appropriate type and the amount of time the orthosis should be worn as it may vary according to the condition it is treating. The treatment plan may also include exercise and physical therapy. Pain medications and anti-inflammatory drugs may also be used.

Other Resources for Patients and Families:  Since orthoses may be uncomfortable, limit a person’s ability to move and do usual activities, and make a person look different, patients need a lot of support and encouragement from family and friends.