Ch 6 - Prosthetic and Orthotics: Spinal Orthoses Flashcards
What does a soft cervical collar provide?
Kinesthetic reminder (through sensory feedback) to limit motion
What are indications of a soft cervical collar?
Symptomatic treatment of soft-tissue injuries of the neck
What is the maximum amount of time a soft cervical collar should be worn?
10 days
Risk of muscle atrophy and psychologic dependency if used longer
What motions do rigid cervical collars restrict?
Cervical flexion, extension, rotation, and lateral bending
Describe a Thomas collar.
Made of firm plastic with superior and inferior padding that wraps around the neck and is secured with Velcro
What are indications for a Thomas collar?
Soft tissue injuries
Describe a Philadelphia collar.
Rigid anterior and posterior plastic reinforcements, secured by Velcro and encompasses the lower jaw and the occiput and extends to the proximal thorax
What are indications for a Philadelphia collar?
Soft-tissue injuries
Stable bony or ligamentous injuries
Wean from immobilization from other collars
What are variants of the Philadelphia collar?
Miami–J
Newport
Malibu collars
Describe a Sterno-Occipital Mandibular Immobilizer.
Cervicothoracic orthosis with chest piece connected by uprights to occipital plate
What are indications of a Sterno-Occipital Mandibular Immobilizer?
Cervical arthritis
Postsurgical fusions
Stable cervical fractures
What directions are controlled with a posterior-type CTO?
Provides good control of flexion/extension; lateral bending and rotation are not well controlled
Describe a Minerva CTO.
Entire posterior skull, band around the forehead to control all cervical motions, and extends downward to the inferior costal margin
What are indications of a Minerva CTO?
Management of unstable cervical spine in preschool age children due to ↑ comfort, ↓ weight, and because it allows early mobilization for rehab
Describe a Halo CTO.
Rigid halo ring secured to the skull with four external fixation pins and four posts attached to the anterior and posterior part of the vest
What are indications of a Halo CTO?
Unstable fractures of the cervical spine (especially high cervical fractures)
Describe a TLSO position.
Sacrum to above the inferior angle of the scapulae
When should TLSO be used for scolosis?
Prevent progression of moderate scoliosis
What are indications for TLSO use?
Truncal paralysis
Post-spinal fusion
Postscoliosis surgery
Describe a Taylor brace.
Flexion/extension control TLSO that consists of two posterior paraspinal bars attached inferiorly to a pelvic band, interscapular band and corset or anterior, fullfront abdominal support
Describe a Kight-Taylor brace.
Consists of a Taylor style TLSO with lateral bands and a thoracic band to restrict lateral bending
Describe a Jewett brace.
Flexion control TLSO consisting of a sternal pad, suprapubic pad, and anterolateral pads connected by oblique lateral uprights counteracted by a dorsolumbar pad
What are indications of a Jewett brace?
- Permit upright position while preventing flexion after thoracolumbar compression fx
- Thoracolumbar Scheuermann’s disease
- Thoracic osteoporotic kyphosis
Describe a Cruciform Anterior Spinal Hyperextension (CASH) brace.
Anterior cross-shaped vertical and horizontal metal uprights with sternal, pubic, posterior, and anterolateral pads. The vertical upright joins the sternal and pubic pad. The horizontal uprights connect the posterior thoracolumbar pad and the anterolateral pads
What are indications of a Cruciform Anterior Spinal Hyperextension (CASH) brace?
- Permit upright position while preventing flexion after thoracolumbar compression fx
- Thoracolumbar Scheuermann’s disease
- Thoracic osteoporotic kyphosis
Describe a Milwaukee brace.
Cervicothoracic-lumbo-sacral orthosis (CTLSO)
• Consists of a rigid plastic pelvic girdle connected to a neck ring over the upper thorax by one anterior, broad aluminum bar and two posterior paraspinal bars
• The cervical ring has mandibular and occipital bars, which rest 20 to 30 mm inferior to occiput and mandible
• Pads strapped to the bars apply a transverse load to the ribs and spine to correct scoliotic curvatures
What are Indications of Milwaukee brace use?
Idiopathic or flexible congenital scoliosis with curves 25° to 40° if the curve apex is located superior to T8
