Spinal orthoses can really be broken down into doing three things. The first one is spinal orthoses always, in order to protect or to help or to help support the spine, makes use of what is called a three-point pressure system. They have a directive force somewhere in the middle and then they have two stabilizing forces on the contralateral side directed in the other direction to stabilize the trunk. Another important goal of spinal orthoses is to increase intracavitary pressure. We are specifically trying to increase the pressure through soft tissue compression. We are compressing the soft tissue around the spine and the musculature enough that we are offloading the vertebral bodies. As we squeeze down and squeeze the fluid, it becomes a little more rigid. We actually get a small elongation of the spine and of those vertebral bodies. It also helps to stabilize the soft tissue if the soft tissue is not functioning correctly. The orthoses, either through the three-point pressure system or the increase in intracavitary pressure, may support those muscles that are no longer performing the function, or they are not working to their optimal advantage. The third goal is kind of more subtle, but has an equally as important for the spinal orthosis. Much of the time, a spinal orthosis is designed to provide a kinesthetic reminder. Many orthoses are like this where we are reminding the patient that they need to be careful. It is something that you feel. It is telling the brain that something is wrong and you need to restrict certain motions in certain ways through the kinesthetic reminder. All orthoses work and utilize at least one of these elements. Most spinal orthoses implement at least two, if not all, of those elements. Almost every orthosis of any kind implements the third point, which is providing a kinesthetic reminder, but it is something that we can use to our advantage. Some spinal orthoses are designed to specifically work just on the idea of providing a kinesthetic reminder to make sure the patient is correcting themselves, for example.
Jared Howell, MS, CPO, LPO
Jared’s current professional role is in Houston, Texas where he serves as the Director of Baylor College of Medicines Master of Science in Orthotics and Prosthetics. Jared continues to be involved in clinical practice practicing prosthetics at least 1 day per week to maintain his skills and relevance in a rapidly evolving profession. Prior to creating and building the program at Baylor, Jared served as the Assistant Director of Prosthetics at Northwestern and started a clinical practice in PA.
Jared’s education includes an undergraduate degree in Manufacturing Engineering from Brigham Young University, Prosthetic and Orthotic Education from Northwestern’s Feinberg School of Medicine, and a graduate degree from Northwestern University’s McCormick School of Engineering in Product Design and Development.
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