An orthopedic brace is not just for disorder and deformities. As a matter of fact, braces are often recommended for anyone who can benefit from a neck or back brace. Bracing offers a safe, non-invasive way to prevent future problems or to help you heal from a current condition, injury, or deformity.
The use of braces is widely accepted. They have been known as successful tools in the treatment of spine disorders. In fact, more than 99% of orthopedic physicians advocate using them! And this includes our orthopedists at Spine & Orthopedic Center. There are more than 30 types of back supports available for spine disorders. We will discuss the most common types of back and neck braces.
A delay in healing can occur in fractures or after a fusion is performed. Therefore, limiting the motion of the spine with a brace enhances the healing process. Not to mention, it can decrease low back pain and discomfort. Two types of back braces are commonly used to limit the motion in the spine: rigid braces and corset braces (elastic braces).
1. Rigid braces: Rigid braces, such as Boston Overlap braces or Thoracolumbar Sacral Orthosis (TLSO), are form-fitting plastic braces. As long as it is fitted, this can limit approximately 50% of the motion in the spine. Fractures (or broken bones) can often be treated with a rigid brace. However, it may also be used after fusion surgery. This type of bracing is heavy and hot, and they tend to be relatively uncomfortable for patients. Therefore, they should be worn when the patient is up but can be removed when lying down.
2. Corset braces (elastic braces): A corset brace is sometimes recommended to limit motion of the spine after a lumbar fusion. This brace helps limit spinal movement by not allowing the patient to bend forward. The bone grows better where there is little motion, and especially in cases where no instrumentation (devices to aid stability) is used, a back brace can help obtain a solid fusion.
People with jobs that involve heavy lifting also sometimes wear corset braces. These braces essentially work by limiting motion and acting as a reminder to use proper body posture when lifting. Always lift with the back straight (not bent forward) and let the large leg muscles to do the lifting.
Additional Back Bracing
Although the two above braces are most common, there are different types. Additional back bracing includes the following:
Postoperative cervical braces
Because of its relatively small size, the cervical spine is well suited for postoperative bracing. The extent of the surgery typically determines the length of time a collar is recommended after surgery.
Many surgeons will ask patients to wear a collar for:
- 6 weeks after a one-level fusion
- Up to 12 weeks after a multi-level fusion
Unfortunately, there is no definitive evidence in the medical literature that points to exactly how long a cervical collar is necessary.
With fixation techniques (such as anterior plates,) the use of these collars are mainly for pain control in the initial postoperative period.
The trochanteric belt is usually prescribed for sacroiliac joint pain or pelvic fractures. The belt fits around the pelvis, between the trochanter (a bony portion below the neck of your thigh bone) and the iliac (pelvis) ridges/crests. It is about five to eight centimeters wide, and it buckles in front, just like a regular belt.
Sacroiliac and Lumbosacral Belts
The lumbosacral belt helps to stabilize the lower back. These belts are usually made of heavy cotton reinforced by lightweight stays. The pressure can be adjusted through laces on the side or backside of the belt. These belts range in widths between 10 to 15 centimeters. The sacroiliac belt is used to prevent the motion by putting a compressor force on the joints between the hipbone and sacrum (base of the spine).
Neck braces are used to provide stability to the cervical spine. Typically, after neck surgery, a trauma to the neck, or as an alternative to surgery. They are probably the type of spinal brace you most commonly see people wearing too. In fact, there are several types available, such as:
This flexible brace is placed around the neck. It is typically used after a more rigid collar has been worn for severe healing. It is used as a transition to wearing no collar.
This is a more rigid/stiff collar that has a front and back piece that attaches with Velcro on the sides. It is usually worn 24 hours a day until your physician instructs you to remove it. This collar is used for conditions such as a relatively stable cervical (upper spine) fracture, cervical fusion surgery, or a cervical strain. Another similar type is the Miami cervical brace.
Sterno-Occipital Mandibular Immobilization Device (SOMI)
A SOMI is a brace that holds your neck in a straight line that matches up with your spine. It offers rigid support for a neck damage. Furthermore, it prevents the head from moving around. And, with this brace, you are unable to bend or twist your neck. Therefore, the restriction of motion helps the muscles and bones to heal from injury or surgery. This brace is a bit more complicated and cumbersome than some of the others. But, it provides excellent support for an injured neck.
The purpose of this brace is to immobilize the head and neck. This is the most rigid of the cervical braces. It is only used after complex cervical spine surgery or if there is an unstable cervical fracture. This brace looks just like it sounds. It has a titanium ring that goes around your head. And it is secured to the skull by four metal pins. Then, the ring attaches by four bars to a vest that is worn on the chest. The vest offers the weight to hold the neck steadily in place. The Halo is worn 24 hours a day until the spine injury heals.