How can you further immobilize a patient with bilateral pars fractures of L5?

Choosing to add a hip spica to the lumbar sacral orthosis (LSO) effectively enhances immobilization in a patient with bilateral pars fractures of L5. The hip spica extends the orthotic support to encompass the pelvis and lower extremities, thereby limiting mobility in multiple planes of motion. This additional support is crucial in cases where there is a risk of further injury or instability in the lumbar spine, particularly in the presence of pars fractures.

The hip spica achieves this by stabilizing the hips and pelvis, which can reduce the load and movement in both the lumbar spine and the sacroiliac joints. This is important as motion in these areas can exacerbate the condition or delay healing.

In contrast, other options, such as adding a cervical collar, would not specifically address immobilization of the lumbar region and could unnecessarily restrict the cervical spine. Increasing lumbar lordosis is contraindicated as it may place more stress on the lumbar vertebrae rather than promoting stability. The use of a pelvic belt can provide some support but is generally less effective than a hip spica in providing comprehensive immobilization and stabilization in this scenario.