Center for Prosthetics Orthotics, Inc.|Seattle|Bellevue|Kirkland

Cruciform Anterior Spinal Hyperextension (CASH)

CASHThoraco Lumbar Sacral Orthoses (TLSOs) are used mainly to treat fractures between T6 and L3. Every TLSO is designed to provide support and immobilization of the thoracic and lumbar regions following various surgical procedures/ traumatic injuries. TLSO are commonly used to help treat post-operative thoracic/lumbar fusion, laminectomy or discectomy, compression fractures, degenerative disc disease, osteoporosis, single column spinal instability immobilization, and facet syndrome.

The Cruciform Anterior Spinal Hyperextension (CASH) brace features anterior sternal and pubic pads to produce a force opposed by the posterior pad and strap around the thoracolumbar region. Sternal and pelvic pads attach to the anterior, metal, cross-shaped bar, which can be bent to reduce excess pressure on the chest and pelvis. The brace is easy to don and doff, but it is difficult to adjust. It provides greater breast and axillary pressure relief than does the Jewett hyperextension TLSO. Two round upper chest pads can be used instead of the sternal pad to decrease discomfort around the breast area.

Motion Restrictions:
• Limits flexion and extension at T6-L1

Indications:
• Flexion immobilization to treat thoracic and lumbar vertebral body fractures T6-L1
• Reduction of kyphosis in patients with osteoporosis

Contraindications:
• Three-column spinal fractures involving anterior, middle, and posterior spinal structures
• Compression fractures caused by osteoporosis
• Ineffective in limiting lateral bending and rotation of the upper lumbar spine

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