What does an orthosis for spinal cord injury patients do, and is it absolutely necessary?
After a traumatic event like spinal cord injury, your doctor will probably have you wear a brace.
A brace helps promote proper form and prevent further injury.
This article will explain the pros and cons of using an orthosis for spinal cord injury recovery and go over the various types of orthoses.
Let’s get started!
What is the Function of an Orthosis for Spinal Cord Injury?
An orthosis for spinal cord injury patients has two primary functions.
The first function is to stabilize the spinal column to promote healing at the injury site.
The second function is to support the affected body parts for functional rehabilitation.
The primary goals of orthoses for spinal cord injury are to:
- restrict spinal column movements to prevent further damage and promote healing
- correct misalignments and stabilize the spinal column
- combat spasticity and mildly stretch tight muscles
- promote proper posture
- reduce weight-bearing and pain at the joints
Types of Orthoses for Spinal Cord Injury
The type of orthosis you will wear will depend on the severity and level of your spinal cord injury.
Not everyone with a spinal cord injury will need orthoses, but those that do can greatly benefit from the additional support.
Let’s go over different types of orthoses that spinal cord injury patients may be advised to wear.
Head and Neck Braces
Those with severe higher level cervical spinal cord injuries (C4 and up) will likely need to use a halo brace to help stabilize their head and neck.
The average head weighs about 10 pounds. A paralyzed neck will not be able to support that much weight, so a halo brace will help provide maximum support while the spinal column heals.
A halo brace consists of a halo that is pinned to the head, a vest, and bars that connect the halo and vest.
Those with less severe cervical spinal cord injuries will probably use a cervical collar. Unlike a halo brace, it is non-invasive and wraps about the neck to support the weight of the head.
A cervical-thoracic orthosis (CTO) will stabilize both the neck and upper back.
A thoracic-lumbar-sacral orthosis (TLSO) will wrap around your entire trunk.
Lastly, a lumbar-sacral orthosis (LSO) will help stabilize the bottom half of the trunk.
A spinal brace will help provide the additional support necessary to maintain an upright sitting position, prevent further harm, and promote healing.
Lower Limb Braces
All spinal cord injury patients will experience at least some weakness in their lower extremities.
This means that regardless of if you have a cervical, thoracic, lumbar, or sacral spinal cord injury, a lower-limb orthosis can be useful.
An ankle-foot orthosis (AFO) can help spinal cord injury patients that have weakness around the ankle. It will help make sure that your foot doesn’t drag while you try to walk and stabilize the ankle.
Those experiencing paralysis from the knee down can use a knee-ankle-foot orthosis (KAFO) and those with paralysis of the entire lower body can use a hip-knee-ankle-foot orthosis (HKAFO).
Upper Limb Braces
The cervical region of the spinal cord innervates the head, neck, and arms.
Therefore, those with cervical spinal cord injuries (injury to the uppermost spinal cord segments that make up the neck area) may need to use an arm brace or wrist brace to manage upper limb spasticity.
Those with thoracic, lumbar, or sacral spinal cord injuries will not have their arms or hands affected by their spinal cord injuries and will not need to use an upper limb orthosis.
Serial casting is used to help relieve severe spasticity.
Essentially, a cast is applied so that there’s slight tension on the spastic muscle. The tension helps lengthen tight muscles and increase range of motion.
It is replaced once a week for up to 12 weeks so that each time a new cast is applied, the muscle gets stretched a little bit more than the previous time.
Not only does serial casting lightly stretch severely spastic muscles, but it also helps prevent those muscles from further tightening.
How Long Do Spinal Cord Injury Patients Need to Wear Orthotics?
How long a person wears an orthosis depends on the severity of their injury. Typically, a spinal cord injury patient will wear a spine stabilizing brace for up to 6 months until the spine heals.
At some point, you’re going to want to start working towards being less dependent on your orthosis.
Ever heard the phrase “use it or lose it”? Well, that’s exactly what happens if you stop using your muscles and rely too heavily on your orthosis. Learned nonuse is when your body gets so accustomed to using the brace that it forgets how to engage your muscles.
The central nervous system is incredibly adaptable and is capable of neuroplasticity (the ability to rewire itself). The damage caused by a spinal cord injury cannot be reversed, but the spinal cord can relearn affected functions.
The best way to promote neuroplasticity is through massed repetition. The more you repeat a weak movement, the stronger the neural pathways will get.
The movement will gradually become more natural until one day, you won’t need the orthosis at all.
Orthosis for Spinal Cord Injury Recovery: Key Points
Orthoses for spinal cord injury patients help protect the spine, promote healing, aid mobility, and ensure proper form.
They add support to any area of the body that needs it from your head to your feet.
An orthosis should be used for short-term support. Prolonged use can result in learned nonuse.
Hopefully, this article helped you better understand how orthoses aid in spinal cord injury recovery. Good luck!
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