US20080208091A1

US20080208091A1 - Lower Back Orthosis

Info

Publication number: US20080208091A1
Application number: US11/994,894
Authority: US
Inventors: Matthias Vollbrecht; Andreas Muhlenberend; Anke Lehmann
Original assignee: Otto Bock Healthcare GmbH
Current assignee: Otto Bock Healthcare GmbH
Priority date: 2005-07-05
Filing date: 2006-06-29
Publication date: 2008-08-28
Also published as: PL1904000T3; DE502006004673D1; CN101217922B; WO2007003168A1; ATE440578T1; US20080208090A1; EP1904000B1; ES2329287T3; DE102005031867A1; ATE485018T1; CN101217921A; PL1904000T6; CN101217921B; US7815585B2; EP1904002A1; WO2007003148A1; DE502006008138D1; EP1904000A1; EP1904000B3; EP1904002B1

Abstract

A lower back orthosis includes a bandage designed to surround the lower back of a patient and a support device connected to the bandage. The support device is formed by a plurality of finger-shaped rods connected directly to one another. The finger-shaped rods are oriented in a longitudinal direction of a spinal column when positioned on a patient.

Description

The invention relates to a trunk orthosis with a bandage designed to surround the trunk of a patient, and with a support device connected to the bandage.
It is known to use trunk orthoses to support and relieve the lumbar spine. It is also known that the orthosis may need to fulfil very different functions here. For instance, it may be necessary to relieve the lordosis area of the spine in its entirety, by bridging said area with the support device. This provides a substantial immobilization of the spine.
It is also known to support the lumbar area or lumbosacral area of the spine during limited mobility. In a subsequent rehabilitation phase, it may only be necessary to provide a certain degree of support by means of a bandage or a slightly strengthened bandage.
DE 202 04 747 U1 discloses a trunk orthosis of the aforementioned type, which is designed for versatile use in different applications and for adjustment to different patients. In addition to the bandage being formed by two overlapping constituent bandages, which is intended to allow the bandage height to be adapted to the patient in question, various support devices are provided for the bandage. In addition to support rods that can be inserted into specially provided pockets, various support devices in the form of a back-support frame to bridge the lordosis area (lordosis correction) or a vertebral link pad to stabilize the movable lordosis area can be secured to the bandage arrangement. If necessary, this spinal column orthosis can be supplemented with a dish-shaped abdominal pad. The various support devices can be attached to the bandage by means of velcro tape fasteners and can thus be easily changed.
A disadvantage of the known trunk orthosis system is that, for a single orthosis, very different support devices have to be made available and used in order to ensure the different application purposes.
The object of the present invention is therefore to design a trunk orthosis of the type mentioned at the outset in such a way that it can be used as flexibly as possible.
According to the invention, this object is achieved, in a trunk orthosis of the type mentioned at the outset, by the fact that the support device is formed by a plurality of finger-shaped rods which are arranged next to one another, are oriented in the longitudinal direction of the spinal column, are directly connected to one another and are made of a flexible plastic.
Thus, in the trunk orthosis according to the invention, the support device is formed by a link system, which is constructed by way of the finger rods and which permits a high degree of flexibility in several ways. The finger-shaped rods are preferably designed such that their length decreases from the center toward the ends of the bandage. At least three final finger-shaped rods at the end of the bandage are of equal length. This allows the trunk orthosis to be adjusted to different girths by separating a suitable number of the finger-shaped rods of equal length from the ends of the support device, in order to adapt the orthosis for smaller girths. For this purpose, it is advantageous if the connection of the at least three final finger-shaped rods can be easily separated.
The finger-shaped rods are connected to one another via their central pieces and have free ends on both sides of the central piece.
The connection of the finger-shaped rods to one another is preferably formed by narrow webs that permit a certain mobility of the finger-shaped rods with respect to one another, while at the same time still ensuring a sufficient strength of the support device in the circumferential direction of the trunk.
The support device is chosen, in terms of the length of the finger-shaped rods, for a predetermined size of patient body. Lordosis support can be achieved by the flexible finger-shaped rods themselves, while maintaining a certain mobility of the lordosis.
The trunk orthosis according to the invention can be easily reconfigured for bridging the lordosis area (lordosis correction) if at least the finger-shaped rods in the center of the bandage have securing devices for correspondingly finger-shaped stiffening rods. The stiffening rods are preferably made of a suitable stiff plastic, and the finger rods made of plastic can be snapped on or screwed on.
For therapy following prolapse of an intervertebral lumbar disc, it may thus be expedient to first provide substantial immobilization by bridging the lordosis area. If the clinical picture improves, the stiffening rods can be easily removed, such that the trunk orthosis according to the invention with the same structure of the finger-shaped rods can then serve to support the lordosis area in which there is now limited mobility.
After substantial relief of pain has been achieved, it can then be advantageous for the support device formed by the finger-shaped rods to be completely removed from the bandage and for a precautionary residual stabilization then to be provided only by the bandage itself, in which case it is possible to exert a slightly increased stabilizing effect by introduction of strengthening means.
To ensure that the support device formed by the finger-shaped rods can be easily removed from the bandage, it is expedient if the finger-shaped rods are secured releasably on the bandage, preferably by means of velcro connections.
Since the support device formed by the finger-shaped rods is preferably mounted on the outside of the bandage, a tightening strap for the bandage can be guided preferably on the finger-shaped rods themselves, if they are provided with guide devices for the tightening strap. The guide devices can be integrally connected to the finger-shaped rods, that is to say they are provided during the injection molding operation for the finger-shaped rods.
In a preferred embodiment, the finger-shaped rods have, along their length, a shape in which, starting from the center, they taper toward the outside, then have a widened free end for comfortable bearing of the ends on the body. The tapering serves to increase the elasticity and adaptability to the lordosis curvature if the stiffening rods are not used. If stiffening rods are used, there is no adaptation to the lordosis curvature, since the lordosis area in this case is bridged.
In the area outside the central finger-shaped rods, the adaptability of the support device can be improved by the finger-shaped rods being interconnected by spring elements, which permit a variation in the distances between the finger-shaped rods, in the side areas of the support device. If two spring elements are provided for connecting the finger-shaped rods, a deliberate inclination of the finger-shaped rods with respect to one another can be achieved. By contrast, the central finger-shaped rods can be connected rigidly to one another by the central pieces and thus form a single central piece that does not permit any variation of the distance between the finger-shaped rods. Analogously, the finger-shaped stiffening rods can be interconnected to form a one-piece stiffening part.
In another preferred embodiment, the bandage has a multi-part design, with a central piece carrying the support device, and with two end pieces that can be connected to each other to close the bandage. Intermediate pieces of different length can be inserted between the central piece and the end pieces in order to adapt the length of the bandage to the trunk of the particular patient. The necessarily strong connection between the parts of the bandage is preferably achieved by means of velcro fasteners, where the ends to be connected to each other can be formed as a flat end provided with velcro fastener elements on both faces, and as a mouth-like end which engages over both faces of the flat end and has matching velcro fastener elements.

The invention will be explained in greater detail below on the basis of illustrative embodiments shown in the drawing, in which:

FIG. 1 shows a plan view of a trunk orthosis laid out flat with strengthening elements for bridging the lordosis area,

FIG. 2 shows a schematic representation of the use of the trunk orthosis according to FIG. 1,

FIG. 3 shows a view of the trunk orthosis according to FIG. 1, laid out flat, and without strengthening rods,

FIG. 4 shows a schematic representation of the use of the trunk orthosis according to FIG. 3,

FIG. 5 shows a view of the bandage, laid out flat, of the trunk orthosis according to FIGS. 1 and 3, after removal of the support device formed by the finger-shaped rods,

FIG. 6 shows a schematic representation of the use of the bandage according to FIG. 5,

FIG. 7 shows a perspective view of a multi-part bandage, laid out flat (and not joined up), of a trunk orthosis according to a second illustrative embodiment of the invention,

FIG. 8 shows a view, according to FIG. 7, of a bandage joined together for a suitable length,

FIG. 9 shows the view according to FIG. 8, with an attached support device and a tightening strap guided through the support device,

FIG. 10 shows the view according to FIG. 9, for the support device stiffened centrally by a stiffening part.

The trunk orthosis shown in FIG. 1 comprises a bandage 1, having a central area 2 of greater height merging into narrower end areas 3, 4 which are intended to surround the trunk and, upon overlapping in the ventral area of the trunk, can be connected to each other, particularly by velcro connections.
A support device 5, secured releasably on the bandage 1, is formed by finger-shaped rods 6 of different length which are arranged next to one another, parallel to the spinal column and parallel to one another, and are connected to one another via web connections (not shown). In the center of the bandage 1, there is at least one finger-shaped rod 6, preferably two finger-shaped rods 6, of greatest length, which are adjoined by finger-shaped rods 6 of decreasing lengths in the direction toward the ends 3, 4. In the illustrative embodiment shown, the final three finger-shaped rods 6′ are of equal length and can be easily separated from one another via the connecting webs, such that the length of the support device 5 can be adapted to the respective girth of the patient's trunk.
It will be seen from FIG. 1 that the six central finger-shaped rods 6″ of greatest length are strengthened by stiffening rods 7 secured on the finger-shaped rods, the stiffening rods 7 having a (shorter) length adapted to the length of the associated finger-shaped rod 6″. Moreover, the shape of the stiffening rods 7 is adapted to the shape of the finger-shaped rods 6″.
The finger-shaped rods 6, in particular the finger-shaped rods of greatest length 6″, have a shape which, with respect to their length, forms a wide central piece 61 at which the connection to adjacent finger-shaped rods 6 is made and which merges into a tapering portion 62, which is in turn adjoined by a once again widened free end piece 63. Accordingly, the stiffening rods too have a wide central piece 71 and, adjoining the latter, a tapered free end piece 72.
The arrangement of the bandage 1 on the trunk can be supported by a tightening strap 8 which, by means of guide hooks 9 injection-molded onto the finger-shaped rods 6, is guided along the length of the bandage 1 in the area of the support device 5. The guide hooks 9 are expediently produced in one piece with the finger-shaped rods 6 upon injection molding of the latter.
FIG. 2 shows that the trunk orthosis shown in FIG. 1, formed with the finger-shaped rods 6 strengthened in the central area by stiffening rods 7, is used to bridge the lordosis area of a patient 10 in a first embodiment of the invention, with application forces being exerted, in accordance with the indicated arrows, above and below the lordosis area and in the abdominal area.
FIG. 3 shows the trunk orthosis according to FIG. 1 without stiffening rods 7. The absence of the stiffening rods 7 means there is no bridging function for the lordosis area, such that the finger-shaped rods 6, which are flexible in their longitudinal direction toward the free ends, can adapt to the curvature of the spinal column in the lordosis area, and this is aided by the tightening strap 8. A supporting force is thus introduced into the spinal column directly in the lordosis area and the abdominal area, as is indicated in FIG. 4.
FIG. 5 shows the bandage 1 after removal of the support device 5 formed by the finger-shaped rods 6, for example by releasing a velcro connection. The bandage 1 in its original form, or if appropriate with inserted or integrated strengthening elements, can then be used for general stabilization of the patient 10 in the lumbar area, for example in order to reduce the risk of renewed intervertebral disc prolapse (FIG. 6).
The illustrated trunk orthosis is therefore adaptable to a certain extent to the patient and, in addition, can be used in different functions, without different support devices having to be used for this purpose.
FIGS. 7 to 10 show a second illustrative embodiment of a trunk orthosis in which, according to FIG. 7, the bandage 1 has a multi-part design, with a central piece 12 forming the wider central area 2, and end pieces 13, 14 forming the end areas 3, 4. An intermediate piece 15, 15′ can be inserted between the central piece 12 and the end pieces 13, 14, it being possible for intermediate pieces 15, 15′ of different length to be made available in order to permit different lengths of bandages 1. FIG. 7 shows an intermediate piece 15 fitted to the right-hand end piece 13 and connected to the central piece 12 and to said end piece 13, whereas, on the left-hand side, the intermediate pieces 15, 15′ of different length that can be connected are shown individually.
When the intermediate piece 15, 15′ of the right length to suit the abdominal girth of the patient 10 has been selected, it is strongly connected to the associated end piece 13, 14 and the central piece 2.
In the illustrative embodiment shown, the strong connection between the intermediate piece 15, 15′ and the end piece 14 is achieved by the intermediate piece 15, 15′ having a flat end 16 which is directed toward the end piece 13, 14 and which is provided on both faces with velcro fastener elements. The end pieces 13, 14 have mouth-like ends 17 which are directed toward the intermediate pieces 15, 15′ and which engage over both faces of the flat end 16 of the intermediate piece 15, 15′ and are correspondingly provided with matching velcro fastener elements, such that a velcro fastener connection with the end pieces 13, 14 is produced on both faces of the flat end 16.
In a corresponding manner, the central piece 2 is designed with flat ends 16 which interact with the mouth-like ends 17 of the intermediate piece 15, 15′ that are directed toward the middle piece 12, to produce a strong velcro connection 16, 17.
FIG. 7 further shows that, on their outer face (the upper face in the drawing), the end pieces 13, 14 have an attached pocket 18 into which the patient 10 can insert his hands in order to secure the bandage 1 around his trunk with a certain tensioning.
FIG. 8 shows the assembled, ready-to-use bandage 1 after selection of the appropriate intermediate piece 15, 15′.
For small girths, the bandage 1 can of course also be assembled without an intermediate piece 15, 15′, by securing the end pieces 13, 14 directly to the central piece 12.
The bandage 1 shown in FIG. 8 performs the function illustrated according to FIG. 6.
To perform the function according to FIG. 4, a support device 5′ is applied to the bandage 1, said support device 5′ consisting of finger-shaped rods 26 which are arranged next to one another and which, in their central areas, are connected to one another by means of spring elements 27 formed in one piece with the finger-shaped rods. The spring elements 27 are U-shaped, the free ends of the U being designed as spring legs connected to the respectively adjacent finger-shaped rod 26, such that a variation in the distance between adjacent finger-shaped rods 26 is made possible by a greater or lesser spreading apart of the legs of the U-shaped spring element 27. Four central finger-shaped rods 26′ are not connected by spring elements 27, but are instead rigidly connected to one another in their central areas, so that they form a unit that is rigid in its longitudinal orientation.
To press the support device 5′ onto the lordosis area of the patient 10, a tightening strap 18 is used which consists of end elements 19 at its two ends and of plastic wires 20 which connect the two end elements 19 and which terminate in a clip piece 21. The end elements 19 can be connected to the end pieces 13, 14 of the bandage 1 by velcro fasteners. A tightening function is achieved by the strip-shaped end elements 19 being guided through a slit-shaped opening of the associated clip end piece 21 and turned through 180°. In the tightened state, the turned end of the end element 19 can likewise be secured with the aid of a velcro fastener, such that the tightening strap 18 is held in a desired tension with the end element 19.
The parallel plastic wires 20 extend through openings in projecting ribs of the finger-shaped rods 26, the central finger-shaped rods 26′ forming a common central piece through which the plastic wires 20 extend. The two plastic wires 20 extending parallel to each other can also be formed by a single plastic wire 20, which is threaded through the openings of the finger-shaped rods 26, 26′ and turned through 180° in the clip end pieces 21, and the two ends of the plastic wire 20 can then be connected to each other, preferably with a connector piece (not shown).
The trunk orthosis shown in FIG. 9 permits effective strengthening of the lordosis area, with good adaptability of the support device 5′ to the shape of the lordosis area. For this purpose, the finger-shaped rods 26, 26′ are also designed with a longer upper free end and a shorter lower free end. Otherwise, the shape of the finger-shaped rods 26, 26′ corresponds in principle to the shape explained with reference to FIG. 1, where the widened end pieces 63 serve to permit the greatest possible surface area of contact on the trunk of the patient 10.
FIG. 10 shows the second embodiment of the invention with a stiffening part 22 which, by means of connecting screws 23, is mounted securely onto the central piece of the support device 5′ formed with the central finger-shaped rods 26′. The stiffening part 22 has stiffening rods 7′ which are adapted to the shape of the central finger-shaped rods 26′ and of which, in the illustrative embodiment shown, four stiffening rods 7′ are provided.
An elastic adaptation of the support device 5′ to the lordosis curvature, by virtue of the elasticity of the finger-shaped rods 26 in their longitudinal direction toward the free ends, is suppressed by the stiffening part 22, such that the trunk orthosis formed as in FIG. 10 permits the support function according to FIG. 2, in which the lordosis curvature is bridged by the trunk orthosis.
The second embodiment of the invention shown in FIGS. 7 to 10 thus permits the application purposes illustrated according to FIGS. 2, 4 and 6, where the multi-part design of the bandage 1 permits convenient adaptation of the length of the trunk orthosis to the trunk of the patient, and where the subsequently secured tightening strap allows the support device 5′ to be pressed onto the lordosis area independently of the length of the bandage 1. In addition, the spring elements 27 permit a good adaptation of the support device 5′ to the trunk of the patient 10 and, if necessary, also a certain inclination of the finger-shaped rods 26 outside of the central area formed by the finger-shaped rods 26′.

Claims

1-22. (canceled)

23. A lower back orthosis comprising:

a bandage sized and shaped to be positioned on a lower back of a patient and including a first end, a second end and a center; and

a support device connected to the bandage, which includes a plurality of interconnected finger-shaped rods oriented in a direction substantially perpendicular to a longitudinal axis of the bandage.

24. The lower back orthosis of claim 23, wherein the plurality of finger-shaped rods decrease in length from the center of the bandage toward the first and second ends of the bandage.

25. The lower back orthosis of claim 23, wherein at least one of the plurality of finger-shaped rods is removably interconnected.

26. The lower back orthosis of claim 23, wherein a plurality of the finger-shaped rods positioned at the first and second ends are of substantially equal length.

27. The lower back orthosis of claim 23, wherein the plurality of equal length finger-shaped rods positioned at the first and second ends are releasably connected to at least one finger-shaped rod positioned at the center of the bandage.

28. The lower back orthosis of claim 23, wherein the center of the bandage includes at least one finger-shaped rod having a securing device for removably securing a finger-shaped stiffening rod thereto.

29. The lower back orthosis of claim 28, wherein a plurality of finger-shaped stiffening rods are secured to a corresponding plurality of finger-shaped rods, and wherein the finger-shaped rods are interconnected to form an stiffening part.

30. The lower back orthosis of claim 23, wherein the finger-shaped rods are releasably secured on the bandage.

31. The lower back orthosis of claim 23, wherein at least two finger-shaped rods are interconnected by a web spanning therebetween.

32. The lower back orthosis of claim 23, wherein the at least two finger-shaped rods are interconnected by a spring element spanning therebetween.

33. The lower back orthosis of claim 32 wherein the distance between the finger-shaped rods are variable.

34. A lower back orthosis comprising:

a bandage sized and shaped to be positioned on a lower back of a patient and including a first end, a second end and a center;

a support device connected to the bandage, which includes a plurality of interconnected finger-shaped rods oriented in a direction substantially parallel to a longitudinal axis of the patient's spine; and

an tightening strap positioned to apply a force to the support device in the direction of the patient's spine.

35. The lower back orthosis of claim 34 wherein the tightening strap is secured to the finger-shaped rods by at least one guide.

36. The lower back orthosis of claim 35 wherein a plurality of guides are intregrally secured to the finger-shaped rods.

37. The lower back orthosis of claim 35 wherein the at least one guide includes at least two parallel wires upon which the tightening strap is positioned.

38. The lower back orthosis of claim 34 wherein the tightening strap is releasably secured to the bandage.

39. An orthosis adapted to be positioned around a lower back of a patient, the orthosis comprising:

a bandage having a first portion, a second portion and a center portion, wherein the center portion is positioned between the first and second portions and is wider than the first and second portions;

a plurality of elongate rods releasably secured to the bandage, each having a first portion, a second portion and a center portion, and wherein the center portion is wider than the first and second portions.

40. The orthosis of claim 39, wherein the plurality of elongate rods are interconnected by one or more web elements spanning therebetween.

41. The orthosis of claim 40, wherein the web elements include spring elements.

42. The orthosis of claim 41, wherein the spring elements are secured to the elongate rods such that the distance between the rods is variable along the spring elements.