Q: My 10 year old son was put in a orthopedic corset for a rare spine disorder. It extended to just on his buttocks to chest. It had eight slightly flexible steels and fastened at the rear. He was able to bend to a certain degree against the steels. When sitting he was kept erect and could lean forwards a little against the steels. The corset was put on rather tight but had no adverse effect once he was used to it. One year on he has outgrown this corset. We thought he would only be in it for about a year but now told it is for the whole of his childhood, adolescence years and maybe beyond. Two weeks ago he was fitted with a new ortho corset which I can only describe as unforgiving an 11 year old. It now extends to completely cover his buttocks and as low at the front as possible. It fit tight underarm to keep him forcibly stretched. It now has 12 steel boning no longer flexible but rigid with the front steel being very wide. The back steels are formed to keep his back in a severe arched position. Bending is no longer an option and sitting is now quite difficult not being able to lean forward against the front steel being rigid and low. He has to sit bolt upright stretched in a arched posture. The corset is worn 23 hours every day. It is now fastened on each side and it can be seen this corset is on much tighter as his trousers are now loose around his waist even with the corset on. I have concerns about this although his doctor says it is OK. The wide front steel is convex, so it is putting a lot of pressure over his tummy area. We have noticed since this corset was fitted he now leaves half his meals because he says he feels full, is this natural? He says he can also feel the pressure of the front and rear steels on his body but they are not making any marks as such. I have been very tempted to loosen the corset at meal times and for periods in the day to give him some relief but not sure if this is advisable. Any advice on this situation for a child would be appreciated ---Keith (9/15/08)
A: Although this particular corset configuration sounds unusual to me, the general effect of epigastric constriction (lower ribcage), is the compression of the stomach. If the hypogastric (lower abdomen) are constricted as well, it prevents the stomach from being pressed downward, thus limiting its ability to expand. The effect is the goal of stomach stapling, which is intent on reducing stomach capacity.
For a growing child with spinal curves, the
trade-off is between redirection of skeletal growth and breathing and eating
Whereas breathing may initially be
compromised in someone with spinal curvature, depending on the degree, the use
of the corrective support may not improve this, as on the one hand it enforces
an upright posture, which helps to expand the chest volume, on the other it
usually constrains epigastric movement. The result is upper thoracic breathing.
For the stomach, gradual adaptation will
minimize the discomfort and the same precautions apply as for fashionable
tight-lacing, in that slowly digesting foods should be avoided. This includes
fatty and or fried foods and red meat in general. One accepted method to deal
with the reduced digestive capacity is to eat slow and chew well, and to eat
four to six smaller meals each day. If this is adhered to, the orthopedic
support can be worn with greater efficacy. Relaxing the support will merely
extend the duration it will be needed, or it may well reduce effectiveness of
Relaxing a support or tight lacing corset
for a meal and then re-lacing it afterwards is not advised, as it will allow for
more food intake than there will be space, which can result in great discomfort.
It is recommended to make as few changes during the day as possible other than
Also, these supports are rarely effective past adolescence.
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