Brace treatment of spinal claudication in an adult with lumbar scoliosis--a case report.

Unlabelled: Although spinal claudication may arise from narrowing of the spinal canal, not all patients with narrowing develop symptoms. The reason why some patients develop symptomatic stenosis and others do not is still unknown. Therefore, the term lumbar spinal stenosis refers to a clinical syndrome of lower extremity pain caused by mechanical compression on the neural elements or their blood supply. Some studies have shown effectiveness of brace treatment with a common supportive LSO. At our Centre the sagittal realignment brace is used for the treatment of chronic low back pain. This is a lumbar lordosing brace theoretically leading to a reduction of the volume in the spinal canal. However a patient with a significant increase in walking distance due to the application of this brace will be presented here.

Material And Method: A 47 year old woman with a 55 degrees lumbar scoliosis, 30 degrees upper lumbar kyphosis and with highest pain levels under medication (Durogesic 25 mg, Ibuprofen 800, Mirtazapin 15 mg) has been treated with a sagittal realignment brace. Self reported walking distance was at around 800 steps before the pain appeared unbearable (since 5 years). Self reported walking distance was recorded (Patients counts) in the brace 2 days and 10 days after adjustment.

Results: Walking distance increased to 8000 steps after 2 days and to 12000 after 10 days while pain intensity decreased only one point in the VRS, however without any further medication.

Conclusions: In contrary to current hypotheses about the aetiology of spinal claudication augmentation of lordosis may lead to a significant improvement of symptoms associated with spinal stenosis and lumbar scoliosis.