Trunk leaning

Trunk leaning

Rick Stapleton

10/4/2011

Hello list-serve,

 

I have a gentleman who was prescribed a TLSO for kyphosis and trunk
leaning. When I evaluated him he really has very little kyphosis but has
anterior trunk lean from bilateral hip flexion contractures of 15
degrees. His physical traits are: 67, 172 lbs, 72 y/o, s/p R THR 1999,
spinal stenosis with fusion T11-S1, L THR 2008. In my opinion none of
the dorsolumbar orthoses or any TLSO that I know of will help with the
anterior trunk lean. The patient is a radiologist who is close to
retiring but currently sits for 10-12 hours 4 days a week in his
practice. He is currently going through PT to work on his hips but the
referring physician is very adamant about fitting him with a TLSO. I
don't see how anything that doesn't cross the hip can exert enough
leverage to correct his anterior lean while supporting a fused spine. Am
I missing something? Is there a simple or straight forward orthosis to
help this gentleman? Is there such a thing as a dynamic TLSHO that
someone would actually wear?

 

My advice to the patient is to work very hard with PT and develop some
sort of exercise routine to counteract the long hours of sitting. He did
comment that when he does retire (very soon) he should have more time to
devote to straightening up. I also told him I would see what any of my
colleagues would recommend for his particular pathology.

 

Thanks in advance for your help,

 

Rick, CPO

 

 

NOTE: The information in this e-mail and any attachments may be
confidential and privileged. Access to this e-mail by anyone other than
the intended addressee is unauthorized. If you are not the intended
recipient (or the employee or agent responsible for delivering this
information to the intended recipient) please notify the sender by reply
e-mail and immediately delete this e-mail and any copies from your
computer and/or storage system. The sender does not authorize the use,
distribution, disclosure or reproduction of this e-mail (or any part of
its contents) by anyone other than the intended recipient(s).

No representation is made that this e-mail and any attachments are free
of viruses. Virus scanning is recommended and is the responsibility of
the recipient.

 


                          ********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.

If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>

OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.

Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.