Phone: 866-782-6258

Orthotics for Fractures of the Spine

Amit V Bhanti, CPO

May 8, 2012



Are there differences in the types of braces you chose based on age or fracture type?  What is the most common orthosis you use? 


Braces can be made with many different materials, many different trim line variants, and many different other parameters.  For any fracture in the spine, I believe it really needs to be a TLSO.  A TLSO can be made in many different ways.  It can be made shorter, low profile, high profile, or it can be made with extension.  A custom-made TLSO is considered the best orthotic intervention for most of the spinal fractures.  The TLSO can be different by brand, by trim line and by materials.  For example, if I have a patient who is a child or an older woman, I might choose a different material.  I might choose a thinner plastic for that patient rather than going with a thicker plastic that I might choose for a 250-pound, 55-year-old male.  For an older woman, I might use a flex foam material with reinforcements with plastic to make it lighter for her and still provide appropriate forces.  The rigidity of the plastic is not what creates the stability or hyperextension.  Usually it is the cylinder created around the patient’s body through a total contact TLSO that reduces the axial loading.  An example I use is to take a piece of paper and shake it.  You see it is very flexible.  However, as soon as you roll it, the same thin piece of paper becomes hard to push on. This is the principle of a TLSO.  When you create a cylinder around a patient's body, the axial loading can be reduced much more effectively.  It does not matter if it is thick or thin as long as it is appropriately fabricated.


amit v bhanti

Amit V Bhanti, CPO

Amit Bhanti is an American Board Certified Prosthetist and Orthotist licensed in the State of Illinois and the Clinical Director and co-owner of Comprehensive Prosthetics and Orthotics (CPO). He also provides patient care at CPO's other satellite locations. Amit has a very successful track record in patient management and as a business owner. During his 3-year tenure as Clinical Director of Orthotics at Hanger Prosthetics and Orthotics in Peoria, he demonstrated exceptional abilities to lead the group, and helped establish a successful residency program in orthotics and prosthetics.

Related Courses

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Presented by Jennifaye V. Brown, PhD, PT, NCS
Recorded Webinar


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Course: #3119Level: Advanced2 Hours
  'Thank you for sharing your knowledge!'   Read Reviews
Research indicated that in inpatient rehab "The largest percentage of time in physical therapy sessions was spent on gait activities" (Jette, et al., Physical Therapy, 2005; 85(3): 238-248, p. 241). Ankle foot orthotics (AFOs) are not issued in inpatient rehab due to the costs and interim interventions such as stabilizing the foot with an ace bandage are not adequate. Facilities do not have access to pre-fabricated AFOs or electrical stimulation units now being used as walking aides to replace AFOs. Focused rigidity casting is widely used in the orthopedic population and can be applied to the neurologic population. This course will provide insight on the use of focused rigidity casting to fabricate training an AFO. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

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Very little research exists documenting the practice and evidence of the physical therapist’s role in recommending an ankle foot orthosis (AFO). The comprehensive examination should be patient-centered and collaborative in nature with the orthotist, but is often absent in rehabilitation practice. This course will review components of a physical therapy AFO examination as presented in the literature and provide evidence of what should be included, deleted or modified based patient impairments, social determinants of health and the presenter's experiences in AFO fabrication. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

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Acute and chronic trauma is very prevalent in the United States, and have been tied strongly to adverse health behaviors and outcomes. This course provides the rehabilitation professional with an overview of the physiology of trauma, as well as practical tools to work with patients who are experiencing trauma. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

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This course will provide participants with essential tools for determining appropriate orthotic management with an ankle-foot orthosis (AFO) based on detailed gait analysis. Evidence-based orthotic interventions will be presented and participants will have opportunities to see orthotic examples and practice application of information through video/paper cases. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

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Recorded Webinar


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Please note: This course series is comprised of the following individual recordings: #4018, #4020, #4022, and #4024

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