Bracing

When you visit our practice for treatment, Dr. Frazier may recommend you wear a brace.  Some patients find braces uncomfortable or inconvenient, but they serve a very important purpose.  Braces are used to immobilize and support the spine.  Sometimes they are also used to correct spinal deformity. We want you to understand how valuable spinal bracing can be to your recovery.

 

What are braces?

Braces are external devices that support the spine’s muscular and bony structures. Braces are categorized as rigid or soft.  Rigid braces are used to restrict movement, while soft, elastic-type braces provide muscular support while allowing movement. 

Commonly used braces include:

  • Cervical collar
  • Soft lumbar corset
  • Rigid lumbar
  • TLSO brace

 

Cervical Collar

A cervical collar may be used after a neck injury or cervical surgery. Cervical collars come in soft or hard varieties.  A soft cervical collar is flexible, wraps around the neck, and is secured by Velcro®. 

Cervical Collar

Dr. Frazier or his staff will tell you when to wear the cervical collar.  Usually, soft collars are used for about 6 weeks after injury or surgery.  A rigid collar is stiff and the front and back of the collar may be secured by Velcro®.  This type of collar is used for more severe cases of spinal instability or injury and may be used for a longer period of time.

 

Soft Lumbar Corset

A soft lumbar corset is primarily used to provide muscular support. A lumbar corset may be used for individuals who have extensive arthritis or mild lumbar instability.  Often, a corset provides pain relief.  The corset may also serve as a reminder to avoid excessive motion of the lower back and may help encourage proper body mechanics, such as good posture.

Our patients have expressed concern that excessive use of a corset might weaken the lumbar muscles. If you use the brace constantly, this will likely occur. For this reason, we do not recommend continuous, daily use of a lumbar corset. Rather, we suggest its use in a task-specific manner. The brace should be employed when you are involved in activities that place your back at risk. When the at risk activity is finished, the brace should be removed.

Use of such a brace should also be done in conjunction with a lumbar strengthening exercise program.  Ideally, the lumbar strengthening exercise program will increase muscle strength, and eventually make wearing the brace unnecessary.

The lumbar corset is also used after most lumbar spinal surgeries to provide additional lower back support, thus preventing muscles from rapidly fatiguing during recovery. The brace also offers that gentle reminder that activities and motion must be limited for healing to occur.

The purpose of the brace is not for complete immobilization. As such, feel free to use the lumbar corset when it helps, and take the brace off when it no longer helps. Most patients will find the brace to be quite helpful for the first 6 weeks after surgery, with diminishing use of the brace, thereafter. We recommend that initially the brace be used whenever you are out of bed for more than 15 minutes. You can begin to wean yourself from the brace whenever you are ready.

 

Rigid Lumbar Braces

A rigid brace is used when, despite surgical correction (or in place of surgical correction), spinal stability has not been fully achieved. For example, some types of spinal fractures can be managed without surgery. Such fractures have their own inherent stability.  The brace provides additional immobilization, which should safely allow the fracture to heal with a minimal risk of further injury. Under these circumstances, this brace must be worn for approximately 3 months whenever the patient is out of bed.

 

After undergoing a very complex spinal surgery, and despite use of internal fixation, the spine may not be completely stabilized. The reason for this may have to do with the severity of the instability, lack of bone quality, location of the surgery, or nature of the deformity. In this situation, a rigid brace may be needed. Here again, the brace is specifically for immobilization and support. It should be worn whenever the patient is out of bed for more than 10 minutes. This brace will be worn for approximately 3 months after surgery. Dr. Frazier will let you know if such a brace is necessary.

Rigid braces are also used for the correction of scoliosis in the growing adolescent.  The Thoraco-Lumbo-Sacral-Orthosis, or TLSO, is a brace crafted of plastic and used to treat scoliotic curves.  These braces are very specific in nature and are used until the adolescent has finished growing (usually until about 16 years of age).  Use of a brace does not always control the scoliosis curvature. Indeed, the curvature in aggressive scoliosis can continue to progress, despite bracing. Surgery to correct the scoliosis may eventually be necessary despite many years of bracing. Ideally, the brace may replace the need for surgery.

The brace for scoliosis is a rigid plastic brace that must be worn 18 or more hours per day. Ongoing brace adjustments are necessary to maximize the scoliosis correction.  If you are required to wear a brace to treat adolescent scoliosis, it will be necessary to visit the clinic every 3 months.

A brace can be an essential component to the successful treatment of your spine disorder.  Although bracing may require you to limit certain activities or form different habits, the support it provides will speed your healing and may prevent further injury.  Dr. Frazier and his staff have a deep commitment to patient education and welcome all questions.