Page 18 - Bauerfeind life 2013.2

18
life
magazine 2013/2
FOCUS
My dream is to use the orthosis
as an exercise tool”
Observational study – conservative treatment
Dr. René Malzkorn used to be a physiotherapist, before working as a senior physician
at the Klinikum Karlsbad-Langensteinbach with Prof. Jürgen Harms. The Nagold-based
­
orthopedic specialist provided critical and constructive support during the wearing
test for the new Spinova back orthoses.
other words, symptoms that manifest as
nerve root pain but are controlled and sup-
ported by soft tissue systems. And it is pos-
sible to manage these symptoms effectively.
How?
Dr. Malzkorn:
With physiotherapy, shock-
wave therapy, local infiltration, osteopathy
and the new orthoses. I can put together a
comprehensive conservative treatment pro-
gram for patients. “Red flag” symptoms such
as incontinence and paralysis that require
quick surgical intervention, which determi-
nes the further course of treatment, are sig-
nificant here. Through treatment, the symp-
toms can also often be completely ascribed
to muscular and fascial systems. Nowadays I
can use an orthosis to actually activate the
musculature, which was not possible in the
past. It is essential to know how to interpret
the symptoms. In an interdisciplinary team
involving a physiotherapist, radiologist and
neurologist, the indication must be defined
based on clear algorithms.
Do you like orthoses?
Dr. Malzkorn:
Admittedly I prefer torso
muscle corsets to outer corsets. As a
physiotherapist, I have always believed
in activating my patient‘s back muscles
rather than passively stabilizing them, so
rigid corset systems were a thorn in my
side. But times change, and so do technol-
ogy and brands. The corset provided the
basis for developing orthoses.
Has the introduction of Spinova changed
your opinion at all?
Dr. Malzkorn:
As a physician, Spinova
offers me a whole new range of possibili-
ties. This system is the result of a com-
prehensive development process, not just
fine-tuning of an existing medical care
product. It has always been my dream to
use the orthosis as an exercise tool. Of
course, there is always the question of who
or what I am intending to treat. Whether
to opt for orthotic treatment is a matter of
individual choice. To begin with, the focus
is on relief, relaxation, extension and pain
therapy, then it shifts to physiotherapeutic
exercise. The Spinova orthoses add a high
degree of customization and flexibility to
this range of therapeutic options.
How did you gather your findings?
Dr. Malzkorn:
Around 40 lumbar spine
patients from my practice were willing to
take part in a wearing test. I and applica-
tion engineers from Bauerfeind adjusted the
new elements of the Spinova module system
to fit the patients and optimized them over
the course of the test period. Each patient
was provided with an appropriate orthosis
for their indication. The intention was for
all patients to provide an assessment of
their orthosis after wearing it for up to three
months.
What were the results?
Dr. Malzkorn:
All the patients reported
that the orthoses were very comfortable
to wear, and many of them also felt that
their pain had been reduced. One patient
in particular benefited from the experience.
He underwent surgery for an intervertebral
disk prolapse 20 years ago, and later went
under the knife again following a relapse in
the same segment. I recently treated him
as he was once again experiencing severe
pain. Another operation would have left him
out of action for a long time, so that was
not an option for him. We treated him with
the Spinova Immo Plus, in combination with
physiotherapy. He spent most of his time in
his office lying down, and when he had ap-
pointments elsewhere he stabilized his back
by wearing the orthosis, which could not
be seen under his jacket. As a result, it now
seems that surgical intervention is no longer
needed.
Like so many patients with intervertebral disk
complaints...
Dr. Malzkorn:
90
to 95 percent do not need
surgery, that is true. Operations performed
too early often have a lasting impact on the
patient‘s wellbeing. Often it is not the inter-
vertebral disk pain that is the crucial factor
here, but the pseudoradicular symptoms; in
Comfortable materials make the orthoses very
pleasant to wear.
Dr. René
Malzkorn,
orthopedic
specialist.
Pictures: Conny Kurz, Stefan Durstewitz