Orthotic treatment of adult scoliosis patients with chronic back pain
Trunk orthoses to support the sagittal profile and to optimize body statics – illustrated by the example of the trunk orthosis system sBrace L.
Case study of an adult scoliosis patient
Patient with degenerative scoliosis and long-term late effects due to traumatic vertebral body fractures between L4 and Th8 and a concomitant spondylolisthesis between L3 and L4. The result: chronic pain, which severely restricted the independent mobility of the patient in everyday life or made it impossible. Due to the spondylolisthesis surgery was planned. This was denied by the patient.
Requirements for trunk orthosis
The requirements for the orthotic construction are: Stabilization of the lumbar and thoracolumbar area of the spine.
Alteration of the pathomechanical stability of the spine in order to counteract spondylolisthesis and to allow the patient a painless posture.
Selection of orthosis type and orthotic design
The basic shape of a sBrace L orthosis module was selected. The preparation of the trunk orthosis is based on body measurements and clinical images without plaster cast.
The deviation of the pelvis in the frontal plane to the right was introduced into the CAD model.
The physiological sagittal profile of the base module was adjusted according to clinical tests and patient morphology.
In addition, the left thoracic, the right lumbar and the left gluteal system were incorporated into the CAD model to ensure the three-point principle for stabilization in the frontal plane. The points of attachment were adjusted in the CAD model according to the morphology of the patient and the functional requirement.
The sBrace L, which is individually produced on a biomechanically standardized basis, is tailored to the patient’s functional requirements by tailoring the margins. Sensitive pressure zones are padded with cushions.
Result: Mobility in everyday life without surgery
The advancement of spondylolisthesis was stopped with the sBrace trunk orthosis and the pain was reduced to a level that would ensure mobility to meet everyday needs. An operation as ultima ratio was averted.