L4 Spinal Orthotics Flashcards

1
Q

Goals of Spinal Orthoses

A
  1. limit motion to reduce pain, protect unstable segments, or facilitate healing following injury/surgery
  2. support the trunk or neck to reduce loads applied to spine during functional activities
  3. Correct or limit the progression of deformity
  4. provide a reminder to the wearer to maintain or initiate active postural corrections
  5. alignment of spinal skeletal structures
  6. reduction of axial loading through spine
  7. increasing intra-abdominal pressure may reduce axial loading
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2
Q

Spinal orthoses DO NOT

A

apply forces to assist movement or substitute for missing muscle function

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3
Q

Cervical Orthoses

A

support spine’s muscular and bony structures

soft or hard, depends on if you want to restrict or allow movement

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4
Q

Cervical orthoses are used for

A

control of unwanted cervical flexion, extension, rotation

after trauma, acute pain, spinal stenosis

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5
Q

Soft Cervical Collar

A

soft foam material with velcro strap

cannot significantly restrict cervical spine ROM

provides partial support of head reducing para-spinal contraction and spasm

recommended use less than 2 weeks

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6
Q

Uses of soft cervical collar

A

used to manage muscle pain and spasms such as spondylosis, minor trauma like whiplash

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7
Q

Hard Cervical Collars

A

rigid or semi rigid

main function is support, limits motion in all planesT

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8
Q

types of hard cervical collar

A

miami j collar
VISTA collar
aspen
headmaster
philadelphia

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9
Q

Indications for hard cervical collars

A
  1. cervical trauma in unconscious pt
  2. jefferson’s fracture
  3. traumatic spondyloisthesis of C2 on C3
  4. dens type 1 fracture
  5. post-op care
  6. anterior discectomy
  7. cervical strain
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10
Q

Philadelphia Collar

A

greater ability to limit movement compared to the soft collar

large hole in the front is designed to accommodate a tracheostomy. also used for postsurgical stabilization

provides slight load reduction

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11
Q

Cervicothoracic Orthosis Types

A

halo
sterno-occipital mandibular orthosis
minerva

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12
Q

Halo

A

-surgically applied by pins which are placed in cranial table with jacket fitted to torso
-more effective than hard collar at restricting motion

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13
Q

Indications for Halo

A

presurgical correction
post op fusion support
alternative to surgery

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14
Q

Minerva

A

removable version of the halo

offers control of motion down to T3

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15
Q

Indications of Minerva

A

-mid to lower cervical spine injuries
-stable upper cervical spine injuries
-can be used with skull fractures when a halo would be contraindicated
-peds due to decreased weight/improved comfort

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16
Q

Cervico-thoracolumbosacral orthosis CTLSO

A

post-operative cervical fusions
a/p control of cervical spine
high compression fractures
osteoporosis
herniated cervical disc
spinal trauma

17
Q

Thoracolumbosacral orthosis

A

Off the shelf = cash, jewett
custom molded

18
Q

TLSO Indications

A

post op fusion
kyphosis
compression fx
osteoporosis
burst fx
spinal stenosis
spinal muscular atrophy
laminectomy
spinal trauma

19
Q

CASH Brace

A

used for cruciform anterior spinal HE

provides flexion control for the lowe rthoracic and lumbar regions via the three point pressure system

20
Q

Forces of CASH Brace

A

post directed forces through sternal and suprapubic pads

anteriorly directed force applied through a thoracolumbar pad

21
Q

Jewett Orthosis

A

limits spinal flexion

reduces discomfort associated with compression fx, degenerative disc disease, kyphosis, osteoporosis, OA

22
Q

Indications for bracing in scoliosis

A

flexible curves with cobb’s angle 10-40°

> 40° indicates surgery
30-40° use of orthosis
10-20° observe

23
Q

Orthopedists typically recommend bracing for scoliosis for peds..

A

who are still growing and have a curvature ≥ 25°

24
Q

Goal of scoliosis brace

A

its to keep the curve from progressing to the level taht surgery is required

some pts achieve curve reduction with bracing

25
Boston brace
3 point pressure system cuts outs to allow body to move difficult to control rotation
26
Cheneau Brace
relatively new with limited research fully custom made controls rotation with extension at shoulders
27
Indications of LSO
post op degenerative disc disease spondyloysis spinal stenosis compression fx herniated disc pain relief postural support reduces lumbar lordosis vasomotor and respiratory support increases abdominal pressure
28
Types of LSO
soft fabric lumbar support molded plastic
29
Post surgical spinal orthoses
surgeon post op orders specify wear time, how to wear, etc logroll technique technique to don brace in bad
30
Spinal fusion
should be wearing spinal orthosis for up to 3 months dictated by surgeons preference