Ali ÖZYALÇIN, Dilek BAYRAKTAR, Mehmet Halit ÖZYALÇIN, Emin ALICI
Journal of Turkish Spinal Surgery - 2026;37(EK-1):27-35
Spinal orthoses are a cornerstone of conservative management for spinal deformities, and their primary objectives are to halt curve progression, to reduce pain, and to preserve function. This study summarizes the historical development, current classifications, indications, fabrication principles, and institutional experience. Orthoses are classified by stiffness (flexible, semirigid, or rigid) and by mode of action (dynamic or passive). Historically, rigid devices were used first. Although effective, they had a propensity for complications such as fixed deformity, muscle atrophy, and pressure-related skin necrosis, which led to the development of semirigid alternatives. Custom cast-based design and accurate pad placement are critical for biomechanical effectiveness; material selection is also important, since overly rigid thermoplastics may diminish the intended dynamic effects. The most common indication is adolescent idiopathic scoliosis. Bracing is initiated for curves of approximately 20 to 40 degrees or when progression is documented; average daily wear of 21 hours and close radiographic follow-up are recommended. Night-time wear can exert greater corrective forces in the supine position, and treatment success improves when combined with physiotherapeutic scoliosis exercises. In addition to use in scoliosis, thoracolumbosacral orthoses are useful in the conservative management of fractures to reduce pain and kyphosis; device selection should consider age, comorbidities, and respiratory tolerance, particularly in young children. For more than three decades, thousands of patients have been treated at our center, and we believe that the outcomes, techniques, and practical insights we have gained will be instructive.
