Yeungnam Univ J Med.  2020 Apr;37(2):84-89. 10.12701/yujm.2020.00150.

Effectiveness of orthoses for treatment in patients with spinal pain

• Choo YJ
• Chang MC

• KMID: 2501414
• DOI: http://doi.org/10.12701/yujm.2020.00150

Abstract

Spinal pain is a common patient complaint in clinical practice. Conservative treatment methods include oral medication, physical therapy, injections, and spinal orthoses. The clinical application of orthoses is debated because of potential complications associated with long-term use, such as muscle weakness and joint contracture. We reviewed the orthoses most frequently used to manage spinal pain. We review the use of soft cervical and Philadelphia collars, lumbosacral corsets, and thoracolumbosacral orthosis to manage spinal pain. Spinal orthoses can help reduce pain by protecting the muscles and joints of the injured spinal region, preventing or correcting malformations, and limiting trunk flexion, extension, lateral flexion, and rotation. The short-term use of spinal orthoses is known to improve pain and disability during the treatment period without significant adverse effects. Spinal orthoses are expected to alleviate pain and improve patients’ lifestyle.

Keyword

Conservative treatment; Orthotic devices; Pain; Spine

Figure

• 

  Fig. 1. Soft cervical collar. The subject is wearing soft cervical collar.

• 

  Fig. 2. Philadelphia collar. The subject is wearing Philadelphia collar.

• 

  Fig. 3. Lumbosacral corset. The subject is wearing lumbosacral corset.

• 

  Fig. 4. Thoracolumbosacral orthosis. The subject is wearing thoracolumbosacral orthosis.

Reference

References

1. Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012; 379:482–91.

2. Salekzamani Y, Mirzaee S, Shakouri SK, Nezami N. Pain relieving effect of thermoplastic lumbosacral orthosis with adjustable posterior pad in chronic non-specific low back pain. Iran Red Crescent Med J. 2011; 13:903–5.

3. Jang SH, Chang MC. Follow-up of at least five years after lumbar transforaminal epidural steroid injection for radicular pain due to lumbar disc herniation. Ann Palliat Med. 2020; 9:116–8.

4. Do KH, Kim TH, Chang MC. Effects of interlaminar epidural steroid injection in patients with moderate to severe lumbar central spinal stenosis. Ann Palliat Med. 2020; 9:163–8.

5. Yang JY. The pathogenesis and medical treatment of spondylogenic pain. Asian Spine J. 2010; 4:57–63.

6. Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016; 352:h6234.

7. van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine (Phila Pa 1976). 1997; 22:2128–56.

8. van Tulder MW, Koes B, Malmivaara A. Outcome of non-invasive treatment modalities on back pain: an evidence-based review. Eur Spine J. 2006; 15(Suppl 1):S64–81.

9. Azadinia F, Ebrahimi Takamjani E, Kamyab M, Parnianpour M, Cholewicki J, Maroufi N. Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J. 2017; 17:589–602.

10. Bible JE, Biswas D, Whang PG, Simpson AK, Rechtine GR, Grauer JN. Postoperative bracing after spine surgery for degenerative conditions: a questionnaire study. Spine J. 2009; 9:309–16.

11. Muzin S, Isaac Z, Walker J, Abd OE, Baima J. When should a cervical collar be used to treat neck pain? Curr Rev Musculoskelet Med. 2008; 1:114–9.

12. Barati K, Arazpour M, Vameghi R, Abdoli A, Farmani F. The effect of soft and rigid cervical collars on head and neck immobilization in healthy subjects. Asian Spine J. 2017; 11:390–5.

13. Richter D, Latta LL, Milne EL, Varkarakis GM, Biedermann L, Ekkernkamp A, et al. The stabilizing effects of different orthoses in the intact and unstable upper cervical spine: a cadaver study. J Trauma. 2001; 50:848–54.

14. Beavis A. Cervical orthoses. Prosthet Orthot Int. 1989; 13:6–13.

15. Mealy K, Brennan H, Fenelon GC. Early mobilization of acute whiplash injuries. Br Med J (Clin Res Ed). 1986; 292:656–7.

16. Rosenfeld M, Gunnarsson R, Borenstein P. Early intervention in whiplash-associated disorders: a comparison of two treatment protocols. Spine (Phila Pa 1976). 2000; 25:1782–7.

17. Ghorbani F, Kamyab M, Azadinia F, Hajiaghaei B. Open-design collar vs. conventional Philadelphia collar regarding user satisfaction and cervical range of motion in asymptomatic adults. Am J Phys Med Rehabil. 2016; 95:291–9.

18. Kim JH, Park YS, Song JC, Shin HS, Chang YC. Prosthetics & orthotics. 3rd ed. Seoul (KR): Topmed;2006.

19. Kaufman WA, Lunsford BR, Lunsford TR, Lance LL. Comparison of three prefabricated cervical collars. Orthot Prosthet. 1985; 39:21–8.

20. Sparke A, Voss S, Benger J. The measurement of tissue interface pressures and changes in jugular venous parameters associated with cervical immobilization devices: a systematic review. Scand J Trauma Resusc Emerg Med. 2013; 21:81.

21. Motiei-Langroudi R, Sadeghian H. C2 body fracture: report of cases managed conservatively by Philadelphia collar. Asian Spine J. 2016; 10:920–4.

22. Morrisette DC, Cholewicki J, Logan S, Seif G, McGowan S. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of lower back pain. Spine (Phila Pa 1976). 2014; 39:1733–42.

23. Rizzone K, Gregory A. Using casts, splints, and braces in the emergency department. Clin Pediatr Emerg Med. 2013; 14:340–8.

24. Sullivan MS, Mayhew TP. The effect of lumbar support belts on isometric force production during a simulated lift. J Occup Rehabil. 1995; 5:131–43.

25. Terai T, Yamada H, Asano K, Nawata A, Iwasaki T, Henmi T, et al. Effectiveness of three types of lumbar orthosis for restricting extension motion. Eur J Orthop Surg Traumatol. 2014; 24(Suppl 1):S239–43.

26. Agabegi SS, Asghar FA, Herkowitz HN. Spinal orthoses. J Am Acad Orthop Surg. 2010; 18:657–67.

27. Schroeder S, Rossler H, Ziehe P, Higuchi F. Bracing and supporting of the lumbar spine. Prosthet Orthot Int. 1982; 6:139–46.

28. Kim MH. A biomechanical effectiveness of corset and back brace for low back pain syndrom. Phys Ther Korea. 1996; 3:59–66.

29. Stauffer RN, Coventry MB. Anterior interbody lumbar spine fusion: analysis of Mayo Clinic series. J Bone Joint Surg Am. 1972; 54:756–68.

30. Prateepavanich P, Thanapipatsiri S, Santisatisakul P, Somshevita P, Charoensak T. The effectiveness of lumbosacral corset in symptomatic degenerative lumbar spinal stenosis. J Med Assoc Thai. 2001; 84:572–6.

31. Vander Kooi D, Abad G, Basford JR, Maus TP, Yaszemski MJ, Kaufman KR. Lumbar spine stabilization with a thoracolumbosacral orthosis: evaluation with video fluoroscopy. Spine (Phila Pa 1976). 2004; 29:100–4.

32. Jacobs E, Senden R, McCrum C, van Rhijn LW, Meijer K, Willems PC. Effect of a semirigid thoracolumbar orthosis on gait and sagittal alignment in patients with an osteoporotic vertebral compression fracture. Clin Interv Aging. 2019; 14:671–80.