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Jennifer C Urquhart, Osama A Alrehaili, Charles G Fisher, Alyssa Fleming, Parham Rasoulinejad, Kevin Gurr, Stewart I Bailey, Fawaz Siddiqi, Christopher S Bailey
OBJECTIVE A multicenter, prospective, randomized equivalence trial comparing a thoracolumbosacral orthosis (TLSO) to no orthosis (NO) in the treatment of acute AO Type A3 thoracolumbar burst fractures was recently conducted and demonstrated that the two treatments following an otherwise similar management protocol are equivalent at 3 months postinjury. The purpose of the present study was to determine whether there was a difference in long-term clinical and radiographic outcomes between the patients treated with and those treated without a TLSO...
April 14, 2017: Journal of Neurosurgery. Spine
Miriam K Minsk, Kristen D Venuti, Gail L Daumit, Paul D Sponseller
BACKGROUND: Bracing can effectively treat adolescent idiopathic scoliosis (AIS), but patient outcomes have not been compared by brace type. We compared outcomes of AIS patients treated with Rigo Chêneau orthoses (RCOs) or custom-molded Boston-style thoracolumbosacral orthoses (TLSOs). METHODS: We retrospectively reviewed patient records from one scoliosis center from 1999 through 2014. Patients were studied from initial treatment until skeletal maturity or surgery...
2017: Scoliosis and Spinal Disorders
E Pola, D Colangelo, L A Nasto, V Pambianco, G Autore, V M Formica, G Maccauro
PAO is an uncommon condition affecting pregnant women during last trimester or early post-delivery period; it is often asymptomatic or presents with pain related to some acute fragility fractures. The diagnosis is often delayed or missed, the etiology remains unknown and no guidelines about treatment have been published. We present one case of PAO in a 33-year-old primigravid woman presenting acute worsening back pain. Our patient was treated with a TLSO brace, oral 25 (OH)-vitamin D supplementation and Teriparatide for 6 months...
October 2016: Journal of Biological Regulators and Homeostatic Agents
Marco Corradin, Federico Canavese, Alain Dimeglio, Jean Dubousset
PURPOSE: Thoraco-lumbo-sacral orthosis (TLSO) is an effective treatment in adolescent idiopathic scoliosis (AIS) patients, but cervical sagittal alignment (CSA) variations after bracing have never been evaluated. The purpose of this study was to assess changes in CSA before, during and after TLSO treatment, and to determine whether patients developed cervical pain. METHODS: This was a retrospective study in 38 AIS patients (33 females; mean age 10.8 years) treated by TLSO...
November 18, 2016: European Spine Journal
Hyeon-Nam Song, Young Mi Kim, Kyoung Kim
[Purpose] This study attempted to examine the impact on the pattern of walking on both level ground and stairs after restricting the movement of the spine and the trunk of the body by using a spinal orthosis. [Subjects and Methods] Forty healthy males in their 20s were selected as the sample, which was randomly and evenly divided into two groups: (1) the WT group (with a thoracolumbosacral orthosis group) and (2) the WOT group (Without a thoracolumbosacral orthosis group). The spinal orthosis used in this study was a thoracolumbosacral orthosis called a plastic body jacket...
July 2016: Journal of Physical Therapy Science
Hesham M Soliman, Ha Nguyen, Frank A Pintar, Narayan Yoganandan, Shekar N Kurpad, Dennis J Maiman
INTRODUCTION: According to the latest version of the Abbreviated Injury Scale (AIS), all Thoraco-Lumbar Compression Fractures (TLCF) with >20% loss of height, were branded code 3 injuries, reflecting a threat for life or permanent disability. However, clinical observation suggests that that TLCF with <40% loss of height and without neurological deficits, have been noted to have a better clinical prognosis, prompting the need to segregate these injuries differently, revise the classification, and review outcomes...
August 2016: Neurosurgery
Winward Choy, Zachary A Smith, Stephanus V Viljoen, Timothy E Lindley, Nader S Dahdaleh
We report a unique instance of a 66-year-old male patient with an unstable three-column thoracic extension injury at the level of T4/5 who was treated with recumbency and bracing without surgery. A posterior long segment fixation was attempted three times on two separate occasions over the course of a week with failure due to difficulty in ventilating the patient during prone positioning, cardiopulmonary arrest, and hemodynamic instability during prone positioning for surgery. The decision then was to treat this fracture with recumbency...
2016: Curēus
Martin Matthews, Suzanne Blandford, Jonathan Marsden, Jennifer Freeman
BACKGROUND: To date the main treatment approach for neuropathic onset scoliosis has utilised thoracic lumbar sacral orthoses (TLSO) to stabilize the spine and enable stable sitting. Dynamic elastomeric fabric orthoses (DEFOs) may achieve both of these aims if used as an early intervention. Due to a lack of evidence in this area, a retrospective audit of case notes was undertaken to understand current orthotic practice investigating the usage, outcomes and clinical characteristics of treated children with neuropathic onset scoliosis...
2016: Scoliosis and Spinal Disorders
N Cobetto, C E Aubin, S Parent, J Clin, S Barchi, I Turgeon, Hubert Labelle
PURPOSE: Clinical assessment of immediate in-brace effect of braces designed using CAD/CAM and FEM vs. only CAD/CAM for conservative treatment of AIS, using a randomized blinded and controlled study design. METHODS: Forty AIS patients were prospectively recruited and randomized into two groups. For 19 patients (control group), the brace was designed using a scan of patient's torso and a conventional CAD/CAM approach (CtrlBrace). For the 21 other patients (test group), the brace was additionally designed using finite element modeling (FEM) and 3D reconstructions of spine, rib cage and pelvis (NewBrace)...
October 2016: European Spine Journal
Devon J O Guinn, Demitre Serletis, Noojan Kazemi
INTRODUCTION: We present a rare case of thoracic vertebral osteomyelitis secondary to pulmonary Blastomyces dermatitides. PRESENTATION OF CASE: A 27-year-old male presented with three months of chest pains and non-productive cough. Examination revealed diminished breath sounds on the right. CT/MR imaging confirmed a right-sided pre-/paravertebral soft tissue mass and destructive lytic lesions from T2 to T6. CT-guided needle biopsy confirmed granulomatous pulmonary Blastomycosis...
2016: International Journal of Surgery Case Reports
Ben Cason, Jack Rostas, Jon Simmons, Mohammed A Frotan, Sidney B Brevard, Richard P Gonzalez
BACKGROUND: The purpose of this study was to prospectively assess the sensitivity of clinical examination to screen for thoracolumbar spine (TLS) injury in awake and alert blunt trauma patients with distracting injuries. METHODS: From December 2012 to June 2014, all blunt trauma patients older than 13 years were prospectively evaluated as per standard TLS examination protocol at a Level 1 trauma center. Awake and alert patients with Glasgow Coma Scale (GCS) score of 14 or greater underwent clinical examination of the TLS...
January 2016: Journal of Trauma and Acute Care Surgery
Edmond H M Lou, Douglas L Hill, Jim V Raso, Marc Moreau, Douglas Hedden
PURPOSE: To determine the reliability of a prognostic curve progression model and the role of the quantity and quality of brace wear for adolescent idiopathic scoliosis (AIS) brace treatment. METHODS: To develop a curve progression model for full-time AIS brace treatment, 20 AIS subjects (Group 1) prescribed full-time thoracolumbar sacral orthosis (TLSO) were monitored and followed for 2 years beyond maturity. The developed curve progression model was: curve progression (in degrees) = 33 + 0...
February 2016: European Spine Journal
Serkan Erkan, Koray Tosyalı, Taçkın Özalp, Hüseyin Yercan, Güvenir Okcu
INTRODUCTION: Burst fractures of the low lumbar spine constitute approximately one percent of all lumbar fractures. There is still no consensus on the optimal treatment of low lumbar burst factures. We aimed to evaluate the functional and radiographic outcomes of conservative treatment in patients with low lumbar burst fracture. METHODS: 15 patients (11 males, 4 females; mean age 32±8) who had low lumbar spine burst fracture treated with a custom-moulded thoracolumbosacral orthosis (TLSO) with a thigh extension were enrolled...
July 2015: Injury
Robert Rizza, XueCheng Liu, John Thometz, Channing Tassone
BACKGROUND: Numerous designs are used to the treatment of Early Onset Scoliosis. For example, a Thoraco-Lumbo-Sacral Orthosis (TLSO) is constructed using Polyethylene (PE). In addition, a series of castings has been implemented using cast material (3M, BSN Medical). The cast material has some significant advantages over the PE design including: growth preserving, improved compliance, decreased invasiveness, delaying or avoiding surgery, and the ability to allow the skin to breathe. However, the mechanical effectiveness of the cast material brace as compared to the TLSO is unknown, thus providing the objective of this study...
2015: Scoliosis
M A Díez-Ulloa, A Gallego-Goyanes
UNLABELLED: The final collapse of a "stable" thoracolumbar burst fracture is difficult to predict. This collapse was prospectively studied radiologically in patients with T12 or L1 burst fractures who, after evaluating the admission x-rays and the CT scan with the patients themselves, opted for a rigid thoracolumbar brace with support in the sternal manubrium (TLSO). On the other hand, patients with rigid braces sometimes have low back pain on follow-up (due to overload of the L5-S1 joints)...
May 2015: Revista Española de Cirugía Ortopédica y Traumatología
John M Wiemann, Suken A Shah, Charles T Price
BACKGROUND: Spinal bracing is widely utilized in patients with moderate severity adolescent idiopathic scoliosis with the goal of preventing curve progression and therefore preventing the need for surgical correction. Bracing is typically initiated in patients with a primary curve angle between 25 and 40 degrees, who are Risser sign 0 to 2 and <1-year postmenarchal. The purpose of this study is to determine whether nighttime bracing using a Charleston bending brace is effective in preventing progression of smaller curves (15 to 25 degrees) in skeletally immature, premenarchal female patients relative to current standard of care (observation for curves <25 degrees)...
September 2014: Journal of Pediatric Orthopedics
Minoo Khanali, Mokhtar Arazpour, Stephen William Hutchins, Reza Vahab Kashani, Heidar Sadeghi, Hossein Vahid Tari
Abstract Background and aim: The objective of this study was to assess the effect of thoracolumbosacral orthoses (TLSOs) on antero-posterior (AP) sway, medio-lateral (ML) sway and displacement of the center of pressure (COP) during a longitudinal study in patients with adolescent idiopathic scoliosis (AIS). Methods: Eight females aged between 12 and 14.5 years participated in this study. Evaluations were performed prior to the TLSO intervention as a baseline condition, after 1 month, and after 4 months of orthosis use by assessing balance when standing statically on different surfaces...
April 9, 2014: Disability and Rehabilitation. Assistive Technology
Grant Wood
BACKGROUND AND AIM: The purpose of this paper is to share with scoliosis professionals the X-rays of different pad placement levels associated with improved curve correction in a case of idiopathic scoliosis (IS). Scoliosis braces of all types and brands utilize common principles of construction that ensure good fit and function. Equally important to the end result is good patient follow-up care and brace quality control by the orthotist. DESIGN AND METHODS: This report reviewed the case of an 11-year-old girl diagnosed with IS, focusing on the in and out-of-brace x-rays, as well as the fit and function of the braces...
2014: Scoliosis
Christopher S Bailey, Jennifer C Urquhart, Marcel F Dvorak, Melissa Nadeau, Michael C Boyd, Ken C Thomas, Brian K Kwon, Kevin R Gurr, Stewart I Bailey, Charles G Fisher
BACKGROUND CONTEXT: Thoracolumbar burst fractures have good outcomes when treated with early ambulation and orthosis (TLSO). If equally good outcomes could be achieved with early ambulation and no brace, resource utilization would be decreased, especially in developing countries where prolonged bed rest is the default option because bracing is not available or affordable. PURPOSE: To determine whether TLSO is equivalent to no orthosis (NO) in the treatment of acute AO Type A3 thoracolumbar burst fractures with respect to their functional outcome at 3 months...
November 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Luigi A Nasto, Debora Colangelo, Valentina Mazzotta, Eugenia Di Meco, Valentina Neri, Riccardo A Nasto, Massimo Fantoni, Enrico Pola
BACKGROUND CONTEXT: Currently, treatment for patients diagnosed with noncomplicated (ie, known infectious agent, no neurologic compromise, and preserved spinal stability) pyogenic spondylodiscitis (PS) is based on intravenous antibiotics and rigid brace immobilization. Since January 2010, we started offering our patients percutaneous posterior screw-rod instrumentation as an alternative approach to rigid bracing. Supposed benefits of posterior percutaneous instrumentation over rigid bracing are earlier free mobilization, increased comfort, and faster recovery...
July 1, 2014: Spine Journal: Official Journal of the North American Spine Society
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