A Comprehensive Narrative Review of Spinal Braces for L5-S1 Pathologies: Efficacy, Applications, and Clinical Considerations

Introduction: L5-S1 pathologies, such as degenerative disc disease, spondylolisthesis, herniated discs, and post-operative conditions, present significant challenges in spinal care due to the essential role of this segment in spinal stability and overall function. Spinal bracing serves as a crucial component of conservative management, offering support, stabilization, and pain relief while aiding rehabilitation. This narrative review provides an in-depth analysis of various spinal braces used in treating L5-S1 pathologies, focusing on clinical applications, biomechanical principles, and effectiveness.

Methods: This review assesses a broad range of braces, including lumbar corset braces, lumbosacral orthoses (LSO), and advanced rigid models such as the Knight-Taylor and Williams braces. It also covers custom-molded thoracolumbosacral orthoses (TLSO), sacroiliac (SI) belts, hyperextension braces, and specialized devices like inflatable lumbar traction braces. The analysis synthesizes data from clinical studies, biomechanical findings, and expert recommendations, comparing braces in terms of support, patient compliance, and effectiveness in managing L5-S1 pathologies.

Results: The review offers a detailed comparison of each brace’s clinical effectiveness, evaluating their biomechanical support, impact on patient compliance, and influence on pain management and stabilization of L5-S1 pathologies. Practical considerations for brace selection, such as specific pathology, patient anatomy, and therapeutic goals, are discussed. Additionally, the implications of brace use on long-term spinal health, quality of life, and potential benefits are outlined, highlighting the role of bracing in comprehensive patient management.

Conclusion : This review serves as a comprehensive resource for clinicians, researchers, and healthcare professionals, providing evidence-based insights into the use of spinal braces for L5-S1 pathologies. The findings support improved decision-making in brace selection, aiming to optimize patient care, enhance therapeutic outcomes, and keep pace with emerging trends in spinal brace technology.