Lumbar Spine Stabilization with a Thoracolumbosacral Orthosis

Evaluation with Video Fluoroscopy

Douglas Vander Kooi, Gregory Abad, Jeffrey R. Basford, Timothy Maus, Michael J Yaszemski, Kenton R Kaufman

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Study Design. L3-L5 vertebral body motion was tracked fluoroscopically as individuals performed flexion-extension movements wearing different thoracolumbosacral orthoses (TLSOs). Objective. To assess the effect of custom fitted TLSOs on lumbar vertebral body motion. Summary of Background Data. Several methods have been used to evaluate dynamic vertebral motion in vivo. Controversy remains regarding the utility of a TLSO in decreasing intervertebral motion in the lumbar spine. Methods. Dynamic motion of the vertebral bodies was assessed fluoroscopically under four conditions: without a brace, with a custom fitted TLSO, with the TLSO and thigh extender at 0° or 15°. Intervertebral motion, i.e., the rotation of one vertebral body with respect to the adjacent body in the sagittal plane, throughout the flexion-extension cycle was used to assess the effect of each condition. Results. The TSLO reduced both the total L3-L5 range of motion and the intervertebral motion at each individual level. Total rotation at L3 with respect to horizontal was reduced from 70° without a brace to 50° with a TLSO. Use of the thigh extender provided an additional reduction to 10°. There was no difference between the 0° and 15° settings. Intervertebral motion was reduced by 40% at both L3-L4 and L4-L5 when comparing no brace to TLSO and an additional 15% when a thigh extender was added. Conclusions. A custom molded TLSO reduces both total L3-L5 motion and intervertebral motion in the lower lumbar spine. These effects are enhanced if a thigh extender is used.

Original languageEnglish (US)
Pages (from-to)100-104
Number of pages5
JournalSpine
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2004

Fingerprint

Orthotic Devices
Fluoroscopy
Spine
Thigh
Braces
Articular Range of Motion

Keywords

  • Brace
  • Lumbar spine
  • Spinal motion
  • TLSO
  • Video fluoroscopy

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Lumbar Spine Stabilization with a Thoracolumbosacral Orthosis : Evaluation with Video Fluoroscopy. / Kooi, Douglas Vander; Abad, Gregory; Basford, Jeffrey R.; Maus, Timothy; Yaszemski, Michael J; Kaufman, Kenton R.

In: Spine, Vol. 29, No. 1, 01.01.2004, p. 100-104.

Research output: Contribution to journalArticle

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abstract = "Study Design. L3-L5 vertebral body motion was tracked fluoroscopically as individuals performed flexion-extension movements wearing different thoracolumbosacral orthoses (TLSOs). Objective. To assess the effect of custom fitted TLSOs on lumbar vertebral body motion. Summary of Background Data. Several methods have been used to evaluate dynamic vertebral motion in vivo. Controversy remains regarding the utility of a TLSO in decreasing intervertebral motion in the lumbar spine. Methods. Dynamic motion of the vertebral bodies was assessed fluoroscopically under four conditions: without a brace, with a custom fitted TLSO, with the TLSO and thigh extender at 0° or 15°. Intervertebral motion, i.e., the rotation of one vertebral body with respect to the adjacent body in the sagittal plane, throughout the flexion-extension cycle was used to assess the effect of each condition. Results. The TSLO reduced both the total L3-L5 range of motion and the intervertebral motion at each individual level. Total rotation at L3 with respect to horizontal was reduced from 70° without a brace to 50° with a TLSO. Use of the thigh extender provided an additional reduction to 10°. There was no difference between the 0° and 15° settings. Intervertebral motion was reduced by 40{\%} at both L3-L4 and L4-L5 when comparing no brace to TLSO and an additional 15{\%} when a thigh extender was added. Conclusions. A custom molded TLSO reduces both total L3-L5 motion and intervertebral motion in the lower lumbar spine. These effects are enhanced if a thigh extender is used.",
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