Thoracolumbosacral Orthosis

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Masaaki Nagata - One of the best experts on this subject based on the ideXlab platform.

  • Herpes zoster-induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report.
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata, Meigen Liu
    Abstract:

    Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft Thoracolumbosacral Orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

  • herpes zoster induced trunk muscle paresis presenting with abdominal wall pseudohernia scoliosis and gait disturbance and its rehabilitation a case report
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata
    Abstract:

    Abstract Tashiro S, Akaboshi K, Kobayashi Y, Mori T, Nagata M, Liu M. Herpes zoster–induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report. Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft Thoracolumbosacral Orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

C. Glorion - One of the best experts on this subject based on the ideXlab platform.

  • Surgical treatment of a 180° thoracolumbar fixed kyphosis in a young achondroplastic patient: a one-stage “in situ” combined fusion and spinal cord translocation
    European Spine Journal, 2010
    Co-Authors: J. C. Aurégan, T. Odent, M. Zerah, J. P. Padovani, C. Glorion
    Abstract:

    An achondroplastic patient with a thoracolumbar kyphosis was first seen at the age of 16 at our institution. His only concern at that time was the aesthetic implication of his deformity. His physical examination was normal except for loss of the neurologic reflexes in the lower limbs. The radiographs showed a fixed 180° thoracolumbar kyphosis with correct frontal and sagittal balances. No spinal cord anomaly was found on MRI. Two years later, he developed a progressive neurogenic claudication of the lower limbs. He was still neurologically intact at rest. The MRI showed an abnormal central spinal cord signal in front of the apex of the kyphosis associated with the narrow congenital spinal canal. In regards to this progressive neurological worsening, a surgical treatment was decided. We decided to perform a front and back arthrodesis combined with a spinal cord decompression without reduction of the deformity. A five-level hemilaminotomy was performed with a posterior approach at the kyphosis deformity. The spinal cord was individualised onto 10 cm and the left nerve roots were isolated. A decancellation osteotomy of the three apex vertebrae and a disc excision were performed. The posterior aspect of the vertebral body was then translated forward 2 cm and in association with the spinal cord. Two nerve roots were severed laterally to approach the anterior part of the kyphosis and a peroneal strut graft was inlayed anterolaterally. A complementary anterior and a right posterolateral fusion was made with cancellous bone. The patient was immobilised in a cast for 3 months relayed by a Thoracolumbosacral Orthosis for 6 months. At 3 years follow-up, the neurogenic claudication had disappeared. No worsening of the kyphosis was observed. His only complaint is violent electric shock in the lower limbs with any external sudden pressure on the spinal cord in the area uncovered by bone.

  • Surgical treatment of a 180° thoracolumbar fixed kyphosis in a young achondroplastic patient: a one-stage “in situ” combined fusion and spinal cord translocation
    European Spine Journal, 2010
    Co-Authors: J. C. Aurégan, T. Odent, M. Zerah, J. P. Padovani, C. Glorion
    Abstract:

    Open image in new window An achondroplastic patient with a thoracolumbar kyphosis was first seen at the age of 16 at our institution. His only concern at that time was the aesthetic implication of his deformity. His physical examination was normal except for loss of the neurologic reflexes in the lower limbs. The radiographs showed a fixed 180° thoracolumbar kyphosis with correct frontal and sagittal balances. No spinal cord anomaly was found on MRI. Two years later, he developed a progressive neurogenic claudication of the lower limbs. He was still neurologically intact at rest. The MRI showed an abnormal central spinal cord signal in front of the apex of the kyphosis associated with the narrow congenital spinal canal. In regards to this progressive neurological worsening, a surgical treatment was decided. We decided to perform a front and back arthrodesis combined with a spinal cord decompression without reduction of the deformity. A five-level hemilaminotomy was performed with a posterior approach at the kyphosis deformity. The spinal cord was individualised onto 10 cm and the left nerve roots were isolated. A decancellation osteotomy of the three apex vertebrae and a disc excision were performed. The posterior aspect of the vertebral body was then translated forward 2 cm and in association with the spinal cord. Two nerve roots were severed laterally to approach the anterior part of the kyphosis and a peroneal strut graft was inlayed anterolaterally. A complementary anterior and a right posterolateral fusion was made with cancellous bone. The patient was immobilised in a cast for 3 months relayed by a Thoracolumbosacral Orthosis for 6 months. At 3 years follow-up, the neurogenic claudication had disappeared. No worsening of the kyphosis was observed. His only complaint is violent electric shock in the lower limbs with any external sudden pressure on the spinal cord in the area uncovered by bone.

Robert Eberl - One of the best experts on this subject based on the ideXlab platform.

  • The influence of brace immobilization on the remodeling potential of thoracolumbar impaction fractures in children and adolescents
    European Spine Journal, 2016
    Co-Authors: Georg Singer, Stephan Parzer, Christoph Castellani, Helmut Wegmann, Franz Lindbichler, Holger Till, Robert Eberl
    Abstract:

    Purpose Different treatment methods including immediate mobilization with or without brace, bed rest or immobilization using Thoracolumbosacral Orthosis have been applied for stable compression fractures of the pediatric spine. The aim of this study was to evaluate the influence of bracing on the remodeling capacity of pediatric thoracolumbar type A 1.2 impaction fractures. Additionally, the prevalence of pain and functional disabilities were assessed. Methods All children treated conservatively between 2000 and 2011 with impaction fractures of the thoracolumbar spine (A 1.2) were included and re-invited for a clinical [including VAS 0–100, Oswestry disability index (ODI)] and radiological follow-up examination. Changes of the sagittal index (SI) at the time of the accident, the latest control visit and at the follow-up examination were analyzed. Results Seventy-two patients with a mean age of 12 years (1.8–18 years) and a total number of 133 fractured vertebrae were included. The mean SI at the time of injury was 0.76 (range 0.45–0.94, SD 0.08); 34 patients with 67 fractured vertebrae were included in the follow-up examination after a mean of 7.9 years (2.4–13.1 years). The mean SI of the 67 affected vertebrae at follow-up significantly increased to 0.92 (range 0.74–1, SD 0.06). The initial treatment regimen (brace vs no brace) did not influence the remodeling capacity. More than half of the patients ( n  = 18, 53 %) complained about occasional back-related pain which was not associated with the remodeling process. The mean ODI was 5.8 (range 0–26, SD 6.6) and the mean VAS of the re-evaluated patients was 87 (range 53–100, SD 14). Conclusions A significant remodeling capacity of thoracolumbar vertebral impaction fractures sustained in childhood is demonstrated. Bracing does not seem to influence the long-term outcome of these injuries. More studies have to be performed to define the role of bracing in these fractures.

  • The influence of brace immobilization on the remodeling potential of thoracolumbar impaction fractures in children and adolescents
    European Spine Journal, 2015
    Co-Authors: Georg Singer, Stephan Parzer, Christoph Castellani, Helmut Wegmann, Franz Lindbichler, Holger Till, Robert Eberl
    Abstract:

    Purpose Different treatment methods including immediate mobilization with or without brace, bed rest or immobilization using Thoracolumbosacral Orthosis have been applied for stable compression fractures of the pediatric spine. The aim of this study was to evaluate the influence of bracing on the remodeling capacity of pediatric thoracolumbar type A 1.2 impaction fractures. Additionally, the prevalence of pain and functional disabilities were assessed.

Syoichi Tashiro - One of the best experts on this subject based on the ideXlab platform.

  • Herpes zoster-induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report.
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata, Meigen Liu
    Abstract:

    Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft Thoracolumbosacral Orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

  • herpes zoster induced trunk muscle paresis presenting with abdominal wall pseudohernia scoliosis and gait disturbance and its rehabilitation a case report
    Archives of Physical Medicine and Rehabilitation, 2010
    Co-Authors: Syoichi Tashiro, Kazuto Akaboshi, Yukiko Kobayashi, Toshiki Mori, Masaaki Nagata
    Abstract:

    Abstract Tashiro S, Akaboshi K, Kobayashi Y, Mori T, Nagata M, Liu M. Herpes zoster–induced trunk muscle paresis presenting with abdominal wall pseudohernia, scoliosis, and gait disturbance and its rehabilitation: a case report. Herpes zoster (HZ)-induced abdominal wall pseudohernia has been frequently reported, but there has been no report describing HZ-induced trunk muscle paresis leading to functional problems. We describe a 73-year-old man with T12 and L1 segmental paresis caused by HZ presenting with abdominal wall pseudohernia, scoliosis, and standing and gait disturbance who responded well to a systematic rehabilitation approach. He first noticed a right abdominal bulge in the 6th postherpetic week, which was gradually accompanied by right convex thoracolumbar scoliosis, pain, and standing and gait disturbance in the 12th week. Needle electromyography revealed abnormal spontaneous activities at rest in the right T12 myotomal muscles, and motor unit recruitment was markedly decreased. We arranged an outpatient rehabilitation program consisting of using a soft Thoracolumbosacral Orthosis for pain relief and trunk stability, muscle reeducation of the paretic abdominal muscles, strengthening of the disused trunk and extremity muscles, and gait exercise. Based on electromyographic findings, we instructed him in an effective method of muscle reeducation. After 4 months of rehabilitation, he showed marked improvement and became an outdoor ambulator. We suggest that electromyography is a useful tool to evaluate clinical status and devise an effective rehabilitation program in patients with HZ trunk paresis.

Emmanuel Chabert - One of the best experts on this subject based on the ideXlab platform.

  • Cost-utility analysis of vertebroplasty versus Thoracolumbosacral Orthosis in the treatment of traumatic vertebral fractures
    International Journal of Health Preference Research, 2017
    Co-Authors: Nadia Yakhelef, Martine Audibert, Bruno Peirera, Antoine Mons, Emmanuel Chabert
    Abstract:

    In this research we compared the cost-utility of vertebroplasty versus bracing for treatment of post-traumatic fractures. Cost and health outcomes were assessed from a prospective, randomized, non-blinded, single-center study that was carried out between May 2010 and November 2011 at the University Hospital of Clermont-Ferrand, France. The study included 99 patients, aged from 18 years to 70 years, suffering from acute non-osteoporotic vertebral fracture. We compared the costs and Quality-Adjusted Life Years (QALY) and assessed the Incremental Cost-Effectiveness Ratio for the two arm groups. Health insurance and patient perspectives were considered. From the health insurance perspective, total cost was €7,267 for the brace group whereas it was €7,365 for the vertebroplasty group (mean difference €75.3; p

  • Cost-utility Analysis of Vertebroplasty versus Thoracolumbosacral Orthosis in the Treatment of Traumatic Vertebral Fractures
    2015
    Co-Authors: Nadia Yakhelef, Martine Audibert, Bruno Peirera, Antoine Mons, Emmanuel Chabert
    Abstract:

    Purpose: To evaluate the cost-utility of Vertebroplasty versus conservative therapy (Thoracolumbosacral Orthosis) for treatment of post-traumatic non-osteoporotic and/or non-neoplastic fractures. Materials and Methods: A prospective, randomized, non-blinded, single-center study was carried out between 2010 and 2013. The study included 99 patients, aged from 18 years to 70 years, suffering from acute non-osteoporotic vertebral fracture. We compared costs and Quality-Adjusted Life Years and assessed the Incremental Cost-Effectiveness Ratio for the two arm groups. Health insurance, patient and societal perspectives are considered. Results: For health insurance perspective, total cost was €7,267 for the brace group versus €7,365 for the vertebroplasty group (mean difference €75.3; p

  • Cost-utility Analysis of Vertebroplasty versus Thoracolumbosacral Orthosis in the Treatment of Traumatic Vertebral Fractures
    2015
    Co-Authors: Nadia Yakhelef, Martine Audibert, Bruno Peirera, Antoine Mons, Emmanuel Chabert
    Abstract:

    Purpose: To evaluate the cost-utility of Vertebroplasty versus conservative therapy (Thoracolumbosacral Orthosis) for treatment of post-traumatic non-osteoporotic and/or non-neoplastic fractures. Materials and Methods: A prospective, randomized, non-blinded, single-center study was carried out between 2010 and 2013. The study included 99 patients, aged from 18 years to 70 years, suffering from acute non-osteoporotic vertebral fracture. We compared costs and Quality-Adjusted Life Years and assessed the Incremental Cost-Effectiveness Ratio for the two arm groups. Health insurance, patient and societal perspectives are considered. Results: For health insurance perspective, total cost was €7,267 for the brace group versus €7,365 for the vertebroplasty group (mean difference €75.3; p