Introduction to CO and CTO (Quiz 2) Flashcards
Cervical Spine Characteristics
compensatory lordotic curve to maintain level gaze
largest spinal canal opening
most horizontal facets ~45 deg
True or False
The cervical spine is the most mobile spinal region
True
Where does the most flexion/extension occur
Cervical and lumbar spine
Where does the most lateral bending occur
Cervical spine
Where does the most axial rotation occur
Cervical Spine (some in thoracic)
Where does most sagittal motion occur (“yes”)
Atlas C0-C1
Where does most axial rotation occur (“no”)
Axis C1-C2
CO Stiffness Classification
Soft collar
semi-rigid collar
rigid collar
True or False
Total Contact cervical motion control can only be in a custom made orthoses
True
What are clinical questions for MD?
1) is there neurological involvement or risk of progression
2) is this cervical spine considered clinically stable
3) what motions should be limited
4) is this patient likely to be compliant
What are typical conditions treated with CO
radiculopathy
whiplash
muscle strain
arthritis
degenerative joint disease
degenerative disk disease
postoperative protection
What are clinical questions for MD?
1) is there neurological involvement or risk of progression
2) is this cervical spine considered clinically stable
3) what motions should be limited
4) is this patient likely to be compliant
Soft Collar CO Characteristics
least restrictive
most readily accepted
easy to don and doff
very low risk for skin breakdown
usually for ambulatory patients
can be fitted “backwards” to hold head in extension
Semi-Rigid Collar Characteristics
moderately restrictive
usually well tolerated
not difficult to don and doff
usually for ambulatory patients but may be used in bed
wide range of sizes, heights, styles
most have integral tracheotomy openings
Philadelphia
Semi Rigid
multiple sizes and heights
interchangeable anterior/posterior sections
snap on thoracic extension
light weight
Aspen
Semi-Rigid
replaceable padding
multiple sizes
occipital support strap
interchangeable anterior/posterior sections
CTO version available
Malibu
Semi Rigid
One size for adults
independent adjustable anterior and posterior heights
Miami J
Semi Rigid
replaceable padding
numerous sizes
interchangeable anterior/posterior sections
adjustable height
donning strap
Stable Jefferson Fracture
Ring of C1
Stable Hangman fracture
C2 neural arch
What can SOMI Brace be used for
stable hangman fractures
stable cervical flexion injuries
degenerative joint disease
degenerative disk disease
post halo post surgery
Typical Conditions Treated with CTO
stable jefferson fracture
stable hangman fractures
type 1 odontoid fractures in geriatrics
hyperflexion injuries C3-C7
hyperextension soft tissue injuries C3-C7
SOMI Brace Characteristics
More restrictive than CO
Lower acceptance rate
more difficult to don and doff
moderate risk of skin breakdown
some designs for non-ambulatory application
more difficult to fit
higher cost than CO
Collar with optional Thoracic Extension
extended lever arm to resist sagittal motion
minimal additional motion control
helps keep collar from displacing
may be useful for obese persons
Semi Rigid CTO
stiffer materials
longer thoracic lever arm
more sternal contact
more motion restriction
some are MRI compatible
many have removable padding
Which semi rigid braces are available in pediatric sizes
Johnson CTO & Aspen CTO
What is SOMI
Sternal Occipital Mandibular Immobilizer
designed for ambulatory and supine use
east to fit and adjust
What is the basic fitting protocol
Select proper style
Stabilize neck
Scoop posterior section
Shape anterior section
Secure orthosis
Sit up to readjust
