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Spinal > Spinal Orthotic Biomechanics > Flashcards

Spinal Orthotic Biomechanics Flashcards

1
Q

A 20 year old male has sustained an L1 burst fracture - What do you recommend?

A

TLSO: Triplanar control

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2
Q

Which orthosis would be indicated for a T9, 2-column compression fracture?

A

TLSO: sagittal/coronal control

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3
Q

Which orthosis would you recommend to manage an anterior compression fracture at T12?

A

TLSO: sagittal control

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4
Q

A patient presents with disruption of the supraspinous ligament, posterior longitudinal ligament and the ligamentun flavum. What is most likely the mechanism of injury?

A

Flexion

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5
Q

When the anterior longitudinal ligament is involved, what is the most common mechanism of injury?

A

Extension

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6
Q

The correct anterior pin placement for a HALO is:

A

10mm superior to the eyebrow and placed above the lateral 1/3 of eyebrow

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7
Q

An adolescent female with scoliosis presents in your facility. Because she is being recommended for orthotic treatment, what presentation would you expect to see?

A

Risser sign of +1-2, Cobb angle of 25-40 degrees

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8
Q

Orthotic management of a T1 fracture should be treated with:

A

A CTO

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9
Q

What is the correct posterior trim line for a thermoplastic TLSO?

A

10 mm distal to spine of the scapula

10 mm above the seat with hips flexed to 90 degrees

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10
Q

Which biomechanical principle would be the most effective in unloading an intervertebral disc?

A

Increased intra-cavitary pressure

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11
Q

List, in order from least to most effective, the following cervical orthoses: SOMI, 4-poster CTO, Miami J, HALO and soft collar

A

Soft collar, Miami J, SOMI, 4 poster CTO and HALO

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12
Q

Which condition should be positioned in sagittal flexion for orthotic treatment?

A

Spondylolisthesis, Spondylolysis and Spinal Stenosis

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13
Q

When is it acceptable to have the aterior apron on a conventional LSO to be shorter than the desired height?

A

Spondylolysis, Spondylolisthesis, or any condition that you treat with sagittal flexion

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14
Q

Unilateral contracture of the sternocleidomastoid that is indicative of torticollis would cause the patient to present with:

A

Lateral head flexion to ipsolateral side and rotation to the contralateral side

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15
Q

Placement of a thoracic band on a conventional LSO should be:

A

10mm distal to inferior angle of the scapula

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16
Q

What is the most important biomechanical principle when managing a neuromuscular spine?

A

Total contact

17
Q

Why is a SOMI not effective in controlling cervical extension?

A

The occipital pad pivots in the sagittal plane and the design does not have enough rigidity to control cervical extension

18
Q

Can a three-column, two level injury be treated orthotically?

A

No, surgical stabilization will be needed prior to orthotic treatment

19
Q

Traumatic spondylolisthesis of C2 is known as:

A

Hangman’s fracture

20
Q

In what order should the HALO pins be tightened?

A

Diagonally opposed pins will be tightened together

21
Q

Increasing the intra-abdominal pressure is used in spinal orthotics to:

A

Reduce axial load on lumbar vertebrae and intervertebral discs

22
Q

What is the method used to find baseline for corset measurement?

A

(inferior costal margin to iliac crest)/2

23
Q

If a patient is unable to tolerate strap pressure in the axilla in a TLSO:sagittal control orthosis, what adjustment might be done?

A

Use a harness chest strap with a sternal plate

24
Q

Which cervical level exhibits the most sagittal motion?

A

The most motion occurs between the skull and C1

25
Q

The Knight orthosis is also known as:

A

LSO: sagittal/coronal control

26
Q

In what position should spinal orthoses be tightened on a patient?

A

Supine

27
Q

Where is the appropriate placement of the paraspinal bars for lumbosacral orthosis?

A

Follow the apices of the paraspinal muscles

28
Q

Why would a Milwaukee CTLSO not be recommended for a person with a paralytic spine?

A

Due to the lack of sensation, the individual cannot provide the active forces (kinesthetic reminder) necessary for correction

29
Q

Hypokyphosis is defined as having a sagittal curve magnitude in the range of:

A

0-20 degrees

30
Q

A 35 year old male is seen at the hospital with a compression fracture of L5. What is your treatmet recommendation?

A

LSO with unilateral hip spica attachment
Due to the increase motion that would occur with stabilizing L1-5, the hip spica is added to immobilize L5 for the fracture to heal without irritation.

31
Q

What is the most likely mechanism of injury for a seatbelt (chance) fracture?

A

Flexion and distraction

32
Q

Which is the only orthosis known to control motion at the atlanto-occipital joint?

A

HALO

33
Q

A patient is seen in the office for treatment of a grade III spondylolisthesis presentation and a 45 degree slip angle. What is the treatment recommendation for the patient?

A

Surgery

Spinal (5 decks)

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