Question
What is an orthosis?
Answer
I am going to get on my soapbox for a minute. I do this because a good portion of the people I talk to do not know where the term orthosis comes from. The word brace is much more common. I tease my students by coughing or correcting them when they use the word brace, and it is partially because it is not as descriptive as it needs to be. When we start to look at nomenclature, what is an orthosis? An orthosis is a device that is used to correct disorders of the limbs, spine or cranium. It can be any type of orthosis. For lack of a better term, it is an orthopedic brace. They are specifically targeted at different segments of the body, but if I am using the term orthosis, it refers to one device, and the term orthoses, it refers to multiple devices. The one that tends to get to us a little bit more is the word orthotic, which is an adjective. I cannot say the patient was fit with a spinal orthotic. Instead, I say the patient was fit with an orthotic device, with orthotic being the adjective modifying device. That is something that we run into all the time with our own students as well. If you are talking about the spinal device, you are talking about the spinal orthosis. This is just important to note as we talk about making sure our medical terminology is correct and appropriate, and that we are interfacing appropriately with the health care team.
The word orthotics is the study or practice of the field, and an orthotist is the individual who specifically trained in a Master’s degree program. It requires a minimum of a Master’s degree, plus a residency, so the orthotist will have the training to provide orthotic devices. This includes fitting, making, building, and recommending them. That is specifically the training program we have here. It includes a Master’s degree plus the additional residency components and clinical practicum sections to be able to qualify them to be an orthotist and sit for those exams.
Naming Orthoses
I want to talk about orthoses being named for the anatomical segment of the body that they support. This is particularly important when looking at shorthand and at quick ways to recommend specific devices. One of the devices we talk about is the cranial remodeling orthosis. We will talk about that. Starting proximally or superiorly and moving inferiorly on the spine and torso, there is the cranial remodeling orthosis (CRO), the cervical orthosis (CO), cervical thoracic orthosis (CTO), thoracic lumbar sacral orthosis (TLSO) and lumbosacral orthosis (LSO). What would CTLSO stand for? CTLSO stands for cervical thoracic lumbosacral orthosis. There are a few pathologies that require you to literally place an orthosis that goes all the way from the cervical spine down through the sacrum. Some cases of scoliosis are a classic example of this. Some cases of severe spinal injury are another classic example of this.
What about SIO? This is sacroiliac orthosis. One term you may never hear is TO. This is make-you-think question. TO, in theory, would stand for thoracic orthosis, but the reality is that because the thoracic spine by itself frequently never has an injury on its own. There is no such thing as a thoracic orthosis.
