Affiliations: Baylor College of Medicine, Houston, TX
Note: [1] With acknowledgments to Mersheed Sinaki, MD and Erick Grana, MD for their expertise and assistance in preparation of this article.
Abstract: Symptomatic involutional osteoporosis is a significant clinical problem. The prevalence of radiographic vertebral compression fractures (VCF) reached 26% in a rigorous population study of men and women more than 50 years old.1 However, only an estimated 8% of the total affected population actually seek medical attention.2–4 Investigations of effective medical therapy have been extensive, while sound studies of the physical therapeutic measures have been relatively few.5–10 Pain and loss of functional mobility result from this disorder. Kyphosis, with or without vertebral compression fracture, is the major structural culprit that produces these disabling clinical problems. Spinal orthoses are used clinically for mechanical support and pain relief of osteoporosis.5,11–13 However, little research exists on the efficacy of orthotics in osteoporosis. This article provides a practical approach to guide the practitioner in orthotic selection for selected patients. New concepts presented may stimulate further research interest and more appropriate orthosis prescription. By focusing on level of fracture, biomechanical deficits, and physiatric team mangement, the end product can better satisfy the patient.
