The MKS Lumbo is a low profile semi-rigid LSO which falls between a regular corset type belt and a rigid anterior posterior lumbar brace. Commonly clients who need the additional support over a regular lumbar belt can often be over braced in a full-rigid LSO for safety, but the Lumbo plugs the transition to fully-rigid support perfectly. We like to think of it as a much improved chairback brace.

What the MKS Lumbo has done, is build upon the original chairback architecture of a posterior rigid para spinal frame and a compressive anterior section; but in reality that is where the similarity ends. The changes that make it standout as a modern reinvention are material choices. We find for clients who require semi-rigid posterior support, additional pelvic and lateral trunk control, and a lowered front for sitting comfort – the Lumbo is ideal.

The flexible plastic is a much improved idea over a fixed rigid posterior frame; which can often be impinging due to non-conformance to the torso. The plastic frame is available in two heights and anatomically shaped at the sides to prevent migration in sitting. This is further enhanced by each side having lateral v fulcrum straps to ensure straps are anchored into the waist, exerting a 3-point correction of the vertebral column; this in turn increases intra-abdominal pressure effectively. The added flexibility is especially helpful to a changing circumference, to be more specific palliative clients.

MKS Lumbo

The 360 degree compressive garment is internal to the frame, which makes the brace feel much more cohesive, stabilises soft tissue, and is an excellent interface for the skin against the frame. As with most of the MKS range, Lumbo incorporates the same simple hook and loop overlap, with convenient hand pockets. This facilitates an easy and repeatable 2-step donning process, making independent donning for clients demonstrating reduced upper limb dexterity or reduced cognitive ability less of a challenge. In addition to two heights, the elastic bandage comes in 2 sizes, simple to size with no option paralysis.

As a guide we would say Lumbo is ideal in cases of:
•    Severe lower back pain
•    Severe lumbar sciatica
•    Spondylolisthesis
•    Facet syndrome
•    Spinal stenosis
•    Vertebral body fractures (suitable for a single column minor stable wedge compression fracture, anterior and minimal middle column  involvement L3/L4 with intact interspinous ligaments, where by a TLSO can not be fitted/tolerated, or neuro/ ortho opinion is for pain only)

For more information about the MKS Lumbo or to arrange a demo please contact the customer services team on 0191 258 8944 or email sales@braceorthopaedic.co.uk 

In our clinic we have found that although recent guidelines on the prescription of belts has in real terms meant a reduced volume for low back pain, we still use the MKS Pontsana lumbar belt as our go to lumbar belt for those other clients referred to us by our orthopaedic colleagues / GPs who still see a merit in the proprioceptive qualities for LBP, but largely now lumbar sciatica, intervertebral disc protrusion/prolapse, spondylolisthesis, and post-intervertebral disc surgery.

More recently we have added another string to the bow of the Pontsana in that we have found its design lends exceptionally well to the management of reducible mild anterior midline incisional or umbilical hernias, for which our referrals are on the increase due to recent changes in operating targets resulting in an increase in conservative management, in addition to those who are just unfit for surgery.

Commonly with this group we have had to deal with frustrating waiting times for made-to-measure options, due to the added appointment times for measurements and fittings, to then ultimately end up with a device for a midline hernia that is often not as user-friendly or helpful as the Pontsana, which requires a single measurement.  Alternative off-the-shelf abdominal / hernia binders have often proven not strong enough in providing adequate reduction of a reducible hernia.

The Pontsana lends itself handily to the task due to its design; the semi-elastic bandaging that is lightweight and breathable adjusts comfortably to the body, but is exceptionally strong.

The other key area is that it has a firm abdominal hook-and-loop section which fastens centre front and is reinforced, lending itself to great compression, with no requirement for an additional hernia pad to be slid in, which is unsightly from a cosmetic aspect and another burden to the client’s donning process.

MKS Pontsana

The lateral reinforcing stays prevent the edges rolling up excessively in sitting, and give added support to the lateral abdomen and trunk which can be weak in most abdominal hernia cases. The front depth, although fixed at 18cm, is ideal for elderly stout female patients who require bust clearance in sitting. It is worth noting that when a hernia approached the larger pendulous side, then the alternative MKS Pontsana Plus with optional and increased front depths solved this challenge.

Posterior paraspinal steel reinforcements in conjunction with the mobile double lateral V-shaped fulcrum hook-and-loop straps help create 3-point correction by facilitating fastening upon the apex of the hernia, and due to the origin of the straps follow the line of the iliac crest to help with migration in sitting by defining the waist.

The simple 2-step donning process is aided by the hook-and-loop overlap with handy hand loops for clients with reduced upper limb dexterity, and allows them to introduce enough tension for reduction of the hernia. The lay-on abdominal closure allows for around 10cm of adjustment in circumference. No tricky hook-and-loop, D-rings, or multiple strap threading: an effective, repeatable donning experience to help with compliance.

Pontsana represents a solution from a single measurement, in a single appointment, that can be donned single-handed.

For more information about the MKS Pontsana or to arrange a demo please contact the customer services team on 0191 258 8944 or email sales@braceorthopaedic.co.uk 

Metastatic spinal cord compression (MSCC) exists when pressure on the spinal cord or its vascular supply occurs; arising from soft tissue tumour, fracture of spinal column, or a combination of soft tissue and bony intrusion. Care of the compressed spinal cord often includes protecting spinal alignment by avoidance or restrictions on range of movement, maintenance of cord perfusion by lying supine.

There are some patients who are too unwell for any intervention and will be given supportive care only. Others, though suitable for treatment are not fit enough for surgery but may be appropriately treated with radiotherapy, and there are those who may have radio resistant tumours, and with poor prognosis too frail to justify the risk of surgery.

Mechanical pain is suggestive of spinal column instability; further damage might be provoked by inappropriate mobilisation pre/post and during treatment. CT, plain X-ray, and MRI may indicate that the spine is not at immediate risk from instability. This will allow cautious movement to proceed. Although imaging is helpful in grading effectiveness of surgical stabilisation procedures, it is difficult to assess the effect of radiotherapy and at what stage mobilisation is safe by imaging alone.

In palliative scenarios, or those clients who are unfit for surgery, who have severe mechanical pain +/- imaging evidence of spinal instability an external spinal support may be indicated alongside the client’s consent.

MKS Lumbo Forte

The MKS Lumbo Forte has been a great success for this group; tolerated exceptionally well for those with metastatic involvement at levels of L4 – L2. The Lumbo Forte has a perfect balance of comfort and support of the elastic bandage wrap intimate to torso, with a semi-rigid frame that is external for great compliance. It is conformable to any shape, offering lateral trunk and pelvic support.

Often a changing torso which is commonly seen in this group of clients with fluctuating BMI in short periods of time can require resizing/or new braces ordering, but the adjustability of the Lumbo Forte has prevented any need. Clients are very well supported by the frame, but do not feel too heavily restricted; the breathable elastic bandage has not been found to irritate skin subjected to radiotherapy. 

For clients who are supine or due to medication and struggle with orthostatic hypotension when brought into an upright/ambulatory state, the compressive nature of the high abdomen section which is mildly reinforced has been helpful in raising blood pressure satisfactorily.

Handily the abdominal front has two independent lay over sections so fit can be tailored to fit the most challenging torsos top and bottom. It has to date accommodated pendulous abdomens, sensitive ribs, and those with a decreased lung capacity competently due to the ability to have independent tensions top and bottom, and this is true of the rigid support whose fulcrums straps have individual straps courses with control of tension and position.

A custom comfortable fit from an off the shelf brace.

For more information about the MKS Lumbo Forte or to arrange a demo please contact the customer services team on 0191 258 8944 or email sales@braceorthopaedic.co.uk 

Post-surgically an LSO can often be recommended, and usually in a timely manner on the ward to facilitate discharge. Severe lumbar sciatica with severe intervertebral disc protrusion/prolapse, radicular lumbar syndrome, and spondylolisthesis are common reasons for surgery, with high incidence in the expanding elderly population.

For most the objective post-operatively is to reduce movement of the vertebrae, facilitate healing of soft tissue, and support any weak musculature. Off-the-shelf LSOs are available to the clinician, and utilised for speed of delivery; but not all prove to be dependable when fulfilling the stabilising role alongside fitting as comfortably as a MTM device on difficult / stout waist shapes, and most importantly for this client group; independent, accurate, repeat donning; more on this later. Often a conventional wrap around LSO is tolerated well but they often lack the posterior depth and reinforcements necessary to support and immobilise the lumbar region effectively.

The MKS spinal range on a whole, but especially the MKS Pontsana Stabil for the above examples has shown to be highly effective at fulfilling all those objectives due to the high level of consideration for materials and design architecture of the LSO.

Often compliance and therefore function of a LSO can be diminished by challenges clients have in correctly donning and doffing the LSO. Post-op precautions often prohibit excessive Anterior / Posterior / lateral flexion or twisting for safety, add to this the possibility of muscle atrophy, limited strength and hand dexterity, and cognitive ability, it is easy to see why discharge can be delayed until a level of competency can be reached, and if not; then ease of donning should still be a priority when a carer is required for this task.

MKS Pontsana Stabil

A LSO is routinely advocated for 6 weeks or more, and depending on the surgeon’s discharge guidelines the don / doff frequency daily over several weeks’ amounts to a huge part of the client’s daily routine, and also a huge factor in failure too. The MKS Pontsana Stabil has an easy 2-step don process; this is facilitated by hand loops on all fastening components so the hand or groups of fingers can be used together.

Step 1 is the firm centre front lay over abdominal support, which has the added bonus of increasing intra-abdominal pressure to relieve intradiscal pressure. In step 2 the lateral fulcrum straps attach to the posterior bridging frame and rods, that provide a 3-point stabilising force of the lumbar region once pulled again to the centre front. This follows the suprailliac crest to aid suspension in preventing migration in sitting, a common problem with a stout female torso is under bust impingement, but the iliac suspension and the sweeping low anterior front – which works intuitively with the increasing posterior depth as waist size increases – has prevented this thus far.

The MKS Pontsana Stabil has no complicated D-rings, side-fastenings, or requirement to stand in a full length mirror to don; as demonstrated recently by a visually impaired client.

The other features which have ensured successful immobilisation alongside comfort and compliance are the semi-elastic bandaging with lateral reinforcing stays that are lightweight, breathable, washable, whilst still conforming to the torso. In addition, for patients who have spinal precautions in place that are not afforded the luxury of sitting on the edge of the bed to don – the slimline Pontsana Stabil can be easily slid through the lumbar curve when supine.

For more information or to arrange a demo of the MKS Pontsana Stabil please contact the customer services team on 0191 258 8944 or email sales@braceorthopaedic.co.uk

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