SPINAL ORTHOSIS

Dr Shivani Verma
 OUTLINE
• INTRODUCTION TO TLSO,LSO,SACRAL ORTHOSIS ‘
• DETAILS OF MILWAUKEE ORTHOSIS
• MECHANISM AND USES OF EACH
Milwaukee Brace
• The Milwaukee brace is a brace given for growing children with dynamic scoliosis.

• It directs transverse and longitudinal forces actively and passively.

• The orthosis consists of a custom moulded or prefabricated plastic pelvic girdle that serves as
the foundation for pelvic positioning to control the lower spine
• The anterior pelvic girdle is extended superiorly to just below the xiphoid and
the ribs, providing an anterior compressive force.
• The remainder of the frame consists of anterior uprights leading to a neck
ring.
• The neck ring has an anterior throat pad and two occipital pads that provide
an additional longitudinal distraction force.
• The lateral pads hold the lateral curves, but do not correct them.
• The pelvic band fixes the pelvis and decreases lordosis.
• The collar head-band applies distracting forces that elongate the spine.
• There are buckles used to distract the brace according to the height of the child.
This is thus a dynamic spinal brace that can ‘grow’ along with the children.
• Conditions Used: Any lateral curvature of the spine - scoliosis and kyphoscoliosis.
LUMBOSACRAL BELT
• very common, and routinely used.
• Vary in rigidity based on the amount and type of metal stays
included.
• Longer length corsets generally are used for more extensive spinal
problems.
• A corset has vertical reinforcements or a rigid posterior plate, but
no rigid horizontal bands.
•They are made of leather or canvas and contain
elastic straps with Velcro fastening for a close fit,
and available off the shelf in various sizes (28′′ to
42’’ waist circumference).
• Uses: Reduces pain by avoiding movement and in reducing contraction of the
• erector spinae and consequently compression of intervertebral discs.
 Sacral Orthosis

• Sacral orthosis are the least restrictive spinal orthosis.

• They provide control of the pelvis as a supportive base for the

rest of the spinal column.

• They are used in healing pelvic fractures, and relieving sacro-iliac

pain (sacroiliitis)
 Sacro-Iliac Corset
• It is a prefabricated device that can be adjusted anteriorly, posteriorly or
laterally with laces or hooks.
• Its superior borders lie at the level of the iliac crest.
• Inferiorly its anterior border lies 0.5 to 1 inch above the pubic symphysis
and its posterior border extends to the gluteal fold.
• This orthosis is thought to act by elevation of intra-abdominal pressure
and stabilization of the sacro-iliac joint and pubic symphysis.
1. Conditions Used: Many painful low back conditions associated with:
2. • Osteoporosis
3. • Lumbar spondylosis
4. • Malignancy
5. • Bad posture
6. • Spondylolisthesis
7. • Lumbosacral strain
8. • Sciatica.