PRELIMS: Spinal Orthosis Flashcards
What are the main objectives of spinal orthoses?
Controlling spinal position using external forces
Applying corrective forces to abnormal curves
Aiding spinal stability
Restricting spinal movement after surgery or trauma
What are the negative effects of spinal orthoses?
Axial muscle atrophy
Promotes contracture of immobilized parts
Psychological dependency
Psychosocial effects
What are the types of cervical orthoses?
Soft and hard collars
Philadelphia collar
SOMI (Sterno-Occipital-Mandibular Immobilizer)
Poster orthoses
Yale cervicothoracic orthosis
TMBJ (Thermoplastic Minerva Body Jacket)
Halo vest
What biomechanical principles apply to cervical orthoses?
Uses the three-point pressure system
Resists gross motion
More difficult to resist intersegmental motion due to cervical spine flexibility
What is the role of the atlanto-occipital joint?
Produces significant flexion and extension
Total flexion: 23°
Total axial rotation: 42°
Lateral bending: 8°
What movement occurs at the atlanto-axial joint?
50% of total cervical rotation occurs here
What are soft collars made of, and what are their functions?
What are soft collars made of, and what are their functions?
What are the types of hard collars?
Thomas Collar – Firm plastic with padding, secured with Velcro
Philadelphia Collar – Made of Plastazote, with anterior and posterior rigid reinforcements
Miami-J, Newport, Malibu, Aspen – Variants with better motion control
What are the indications for the Philadelphia collar?
Soft tissue injuries
Stable bony or ligamentous injuries
Weaning off more restrictive orthoses
What is the purpose of a poster orthosis?
Controls flexion/extension
Does not control lateral bending or rotation well
Bulkier but cooler than cervical collars
What is the Yale orthosis?
A cervicothoracic orthosis
A modified Philadelphia collar with extended support to thorax
What is the SOMI (Sterno-Occipital-Mandibular Immobilizer)?
Rigid anterior chest piece and shoulder straps
Can be applied without moving the patient
Restricts flexion-extension
Used for cervical arthritis, post-surgical fusions, and stable cervical fractures
What is a Halo orthosis, and what is it used for?
Best control of motion in all planes
Indicated for unstable fractures of the cervical spine
Uses metal or graphite ring attached to the skull with fixation pins
What are complications of Halo orthosis?
Pin loosening or slippage
Pin-site infections
Pressure ulcers
Less common: reduced vital capacity, neck pain, brain abscess, psychological trauma
What are common lumbosacral orthoses?
Chairback brace – Provides motion restriction
Williams brace – Allows flexion but limits extension
What are common thoracolumbosacral orthoses?
Taylor orthosis – Posterior spinal support
Chairback with cowhorn – Adds lateral stability
Molded jackets – Full trunk stabilization
Jewett hyperextension brace – Limits spinal flexion
What are the types of scoliosis braces?
CTLSO (Cervicothoracolumbosacral Orthosis)
TLSO (Thoracolumbosacral Orthosis)
LSO (Lumbosacral Orthosis)
