For a patient with lower lumbar stenosis, what alignment should an LSO be set in?

For a patient with lower lumbar stenosis, the alignment of a lumbosacral orthosis (LSO) should be set in flexion. This position is beneficial because it decreases the compressive forces on the spinal canal and nerve roots, thus alleviating pain and neurological symptoms caused by the stenosis.

In flexion, the lumbar spine opens up, which allows for more space in the intervertebral foramen and spinal canal. This can lead to improved symptoms for individuals suffering from conditions like lumbar stenosis, where there is narrowing of the spinal canal and potential impingement of the nerves.

While neutral alignment and other positions like extension or lateral bending may serve specific purposes in different conditions, they do not offer the same decompressive benefits for lower lumbar stenosis. Neutral alignment maintains spinal stability, but does not actively reduce pressure on constricted areas. Aligned in extension could potentially increase pressure on the affected nerves, exacerbating symptoms. Aligned in lateral bending, meanwhile, does not provide the necessary support to decompress the lumbar region effectively.

Therefore, aligning an LSO in flexion is aimed at providing the most relief for patients suffering from lower lumbar stenosis.