Welcome to the NHS Scotland Spinal Orthotics Clinical Decision Support Tool. This resource has been created to direct Orthotists to make evidence based decisions when selecting Spinal Orthoses for their patients.
The tool is based on a systematic literature review carried out in 2018, which was refreshed in 2023. However, the evidence base is updated at regular intervals and any treatment changes required as a result of new evidence, newly available product, or changes to best practice are updated on the pathway as required.
It is designed to assist Health Care Professions Council (HCPC) registered Orthotists in selecting the brace that has shown to give the greatest benefit for patients with spinal trauma or a number of other pathologies in terms of restriction of motion within the spine to allow healing, reduction in spinal pain, improved spinal posture when upright, or improvement in function and is based on the available evidence and the knowledge and skills gained via a Qualification in Prosthetics and Orthotics leading to registration with HCPC.
This tool should not be used to guide an orthotic prescription unless used by a health care professional with relevant competencies.
Although specific spinal braces have been identified in the pathways, the products recommended in this tool are examples of types of Orthoses which are either quoted in the literature or are in current common use and should be fit for purpose for the level of spinal injury sustained.
These examples are not exhaustive and are by no means the only appropriate brace. Other spinal braces with similar properties can be used by the prescribing Orthotist based on clinical presentation.
Use of specific braces will change periodically as new and suitable products become available. Product choice is dependent on the preference of each Health Board. The final decision lies with the Orthotist to choose which product is best for the individual patient based on the features of the orthosis, how it will fit the patient, availability, cost, familiarity and individual clinical decision making.
The tool was created by an editorial group within NHSGGC and NHS Grampian and was sponsored by the Scottish Clinical Orthotic Leads Group.