Diário da Espinha

The Development of TLI (Thoracolumbar Lordotic Intervention) as an Effective Bracing Concept for the Postural Spinal Problems - A Review

Abstract

Piet Van Loon and Ruud Van Erve

Introduction: Gaps in knowledge in biomechanics on how the human spine develops itself to the adult posture still exist. It is clear that the huge increase in spinal problems do lack a sound etiologic base, on which effective preventive, conservative and surgical measurements should be based. An innovative technique to correct scoliosis and kyphosis in a non-surgical way is found in the TLI (thoracolumbar lordotic intervention) brace that is based on reversing of the external etiologic factors. Method: A search in older or neglected orthopedic and biomechanical literature around spinal deformities was done to support the clearance of `Idiopathy` in spinal deformities. Own research is described on the effectiveness of treatment by braces Results: Older literature on postural development was gathered. Environmental factors like sitting were once investigated as causes for deformities and could be revisited. The vulnerability of young tissues and early deformability of especial the thoracolumbar spine (in school and child’s labor) was known and well described. The work of Milan Roth on the essences of growth in the neuro-osseous growth relations showed itself a missing link in ongoing discussions on etiology. We related own observations on the detectable signs of raised tension in system during growth to the tension Roth described on cell biologic level. In the TLI brace technique, based on restoration of the crucial thoracolumbar lordosis in order to get healthy posture proof of the reproducibility of older knowledge could be given. The working mechanism of thoracolumbar lordotic intervention (TLI) was published and a pilot study with 91 children wearing this brace revealed good results and even true correction of scoliotic curves was reached. The events in the sagittal plane during (early) growth can be seen as decisive for the postures later in adulthood.