Postoperative stabilization of the posttraumatic thoracic and lumbar spine: a review of concepts and orthotic techniques.
A review of 109 case histories of patients who had undergone a spine fusion and/or posterior instrumentation procedure for thoracic and/or lumbar spine trauma was performed with respect to efficacy of several postoperative external splinting techniques. These data formed the basis for a review of external spinal splinting techniques. The type of orthosis that appears to offer the most efficacious immobilization and maximum patient comfort for fractures in the upper thoracic region in a body shell jacket extending from the submental and suboccipital regions to the lumbar region (modified Minerva jacket). To gain a lower point of fixation in patients with mid-to-low lumbar fractures, it was found that an extended body shell or an extension of a body jacket to one leg (hip spica) was necessary. Thoracic and thoracolumbar injuries may be stabilized with either a Jewett brace or a body jacket. The lack of maintenance of the cylindrical body shell, as well as excessive discomfort, make the Jewett brace and similar orthotic devices a second choice to body shell jackets for fractures in this region. The application of plastic polymer (Thermoplast) to spine splinting techniques offers the patient increased comfort and stability, as well as facilitating easy application and a more snug fit.
Benzel
E C
EC
Division of Neurosurgery, Louisiana State University Medical Center, Shreveport 71130-3932.
Larson
S J
SJ
D004867:Equipment Design; D006801:Humans; D008161:Lumbosacral Region; D009989:Orthotic Devices; D011182:Postoperative Care; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000503:physiopathology / Q000628:therapy*; D013909:Thorax; D016138:Walking