The Physiologic brace is a sagittal realignment brace. This low-profile brace addresses back pain and spinal instability for patients with thoracolumbar kyphosis and lumbar kyphosis. Each brace is custom-designed and fitted.

kyphosis, flatback, sagittal spine

Kyphosis in the thoracolumbar/lumbar region differs from thoracic kyphosis – a condition which creates a rounded, hunched over appearance. When kyphosis occurs in the thoracolumbar or lumbar spine, it creates a flat-back appearance since the natural arch of the lower back pulls backward. This flattening can sometimes be a source of chronic lower back pain in adults.

The Physiologic brace uses sagittal forces to attempt correction and reduce pain in adults with thoracolumbar or lumbar kyphosis. This condition may also be accompanied by a mild scoliosis, but not always (1). Some adults who have previously worn scoliosis braces (not 3D style braces) have experienced flatback, and the problems associated with flatback. Those braces failed to address the sagittal plane and “reduced sagittal diameter” (2). This side effect may be the cause of lumbar back pain in formerly braced patients.

Physiologic Brace Success Story

We recently braced a young adult from California who was in significant pain due to a thoracolumbar kyphosis. His parents had taken him to see top spine doctors in New York and Los Angeles with no acceptable solutions offered. The patient, a college student, was not interested in surgery or continual pain medication.

The patient’s mother found us online and called to inquire. We asked her to share his x-rays with us. After seeing them, Dr. Marc felt this young man might be a candidate for the Physiologic® brace but wanted to evaluate him to be sure. Fortunately, Dr. Marc was scheduled to be in California in late January. While there he evaluated the young man, determined the Physiologic brace would indeed be appropriate and measured him for the brace.

A couple of weeks later, the young man and his mom made the trip to Boston so he could be fit with the brace. His pain reduced significantly in the brace, almost immediately. While here, he also participated in a few hours of scoliosis-specific exercise instruction to help re-establish lordosis in the thoracolumbar spine. We are happy to report that months later, the combination of bracing and spinal exercises are still working well for him and his pain levels have greatly reduced.

physiologic brace, brace for thoracolumbar kyphosis
The Physiologic Brace is relatively small and compact. It is fairly easy to hide under clothing. It was developed in Germany in 2004 and in the US, it is only available at Scoliosis 3DC®.

(1) Weiss HR, Dallmayer R, Stephan C. First results of pain treatment in scoliosis patients using a sagittal realignment brace. Stud Health Technol Inform 123: 582-585, 2006.

(2) Willers U, Normelli H, Aaron S, et al. Long-term results of Boston brace treatment on vertebral rotation in idiopathic scoliosis. Spine. 1993;18:432–5.

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