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Orthotic Fitter > Spinal Orthoses > Flashcards

Spinal Orthoses Flashcards

1
Q

Extrinsic Stability

A

Muscles from back/abdomen
Flexors - Psoas & Abdominals
Extensors - Erector Spinae & Paraspinals

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2
Q

Intrinsic Stability

A

Ligaments and discs
Ligaments: transfer loads & smooth motion between linkages
Discs: shock absorption

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3
Q

Function of the Orthoses

A

Immobilize and reduce gross spinal motion
Support or stabilize individual motion segments, reduce planar motion, reduce effects of gravitational axis and loading on vertebral bodies or intervertebral discs
Prevent or correct a deformity (provide neutral alignment)

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4
Q

Functional Rigidity

A

Flexible, semi-rigid, rigid

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5
Q

Foam Collars

A

Primarily a kinesthetic reminder
Indicated for soft tissue injuries (whiplash)

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6
Q

Reinforced collars / Soft molded collars

A

Kinesthetic reminder

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7
Q

Rigid Cervical Orthoses

A

Philadelphia, Miami J
Extends to manubrium, occipital tuberosities & region above scapular spine.

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8
Q

SOMI

A

Sterno-Occipital-Mandibular Immobilization

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9
Q

Minerva

A

Semi rigid anterior (mid-chest to chin) and semi-rigid posterior (mid-dorsum to parietal area of skull)
Padded band that extends & encircles the forehead.

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10
Q

HALO

A

Provides tri-planar motion control
Halo ring fixed to skull with 4-8 pins, chest jacket & superstructure that connects ring & jacket

Pins do not penetrate the skull. They penetrate scalp, subcutaneous tissue, epicranial aponeurosis & pericranial outer table of compact bone

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11
Q

Thoracic Band

A

Posterior upper limit ~1” below the inferior angle of the scapulae.

Prevents impingement during arm movement, limits lumbar extension with the pelvic band.

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12
Q

Pelvic Band

A

Posterior lower limit, as low as possible - to the sacrococcygeal junction + 1/2” clearance when sitting in flat chair.

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13
Q

Paraspinal Bars

A

Follow apices of paraspinal musculature without contacting the muscle bellies. Structural stability & counterforce to anterior apron.

TLSO - extends to spine of scapulae.

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14
Q

Lateral Uprights

A

Located midline, attachment for apron & structural integrity. Resist lateral flexion of upper lumbar / lower thoracic.

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15
Q

Abdominal Support/Apron

A

Below xyphoid process, above symphysis pubis.
As snug as possible.

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16
Q

Thigh Cuff

A

Attachment to TLSO, LSO to limit gross motion of lower lumbar and pelvis.

17
Q

LSO/TLSO Components

A

Thoracic Band
Pelvic Band
Paraspinal Bars
Lateral Uprights
Abdominal Support/Apron
Thigh Cuff

18
Q

LS Corset with Metal Stays

A

“flexible” devices
Increase intracavity pressure
Can be effective for pain management
Long-term use can lead to atrophy of musculature

19
Q

LSO Sagittal Control

A

Reduces gross motion in sagittal plane
Low back pain, weakness because of arthritis

20
Q

LSO Sagittal-Coronal Control

A

Same components as a knight LSO

21
Q

TLS Corset

A

Increases leverage of flexible LS corset system.
Posteriorly, added shoulder straps
Mainly a kinesthetic reminder

22
Q

Hyperextension Orthoses (Jewett/CASH)

A

Controls just one plane of motion - sagittal.
Limits forward flexion by using three-point pressure system

23
Q

Jewett Orthosis

A

Limits flexion/anterior motion following injury to body of vertebrae
Aluminum frame, sternal pad, suprapubic pad, posterior thoracolumbar pad
3-point pressure system

24
Q

CASH orthosis

A

Cruciform Anterior Spinal Hyperextension

Often for geriatric patients
Little to no lateral support
Limits spinal extension (spondylolisthesis)

25
Q

Body Jackets (LSO/TLSO)

A

Plastic Shell
Prefabricated or custom made to model of patient
Anterior overlap or bivalve openings
Anterior or posterior openings for lateral curvature of the spine.

26
Q

LSO Trim Lines

A

Ant Sup: @ / just below xyphoid
Ant Inf: Superior to symphysis pubis
Post Sup: 24mm inferior to inferior angle of the scapula
Post Inf: @ SC junction or apex of gluteal mass
(Typically extend apex to g-fold when user has spinal involvement of lower lumbar region)

27
Q

TLSO Trim Lines

A

Ant Sup: inferior to sternal notch
Ant Inf: Superior to symphysis pubis
Post Sup: inferior aspect of spine of scapula
Post Inf: @ SC junction or apex of gluteal mass
(Typically extend apex to g-fold when user has spinal involvement of lower lumbar region)

28
Q

Negative effects of Spinal Orthoses

A

Muscle atrophy, joint contracture, hypermobility, respiratory difficulties, poor appearance, noncompliant users

29
Q

Wearing schedule

A

Gradual acclimation to full time wear
immediate wear vs. occasional wear

Orthotic Fitter (30 decks)

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