Spinal Orthotics

Question 1

Name 3 ways to manage T11 anterior compression fractures orthotically?

Answer 1

Jewett
Taylor (dorsal lumbar)
Body Jacket

Question 2

What is the biomechanics principle of a Jewett Brace?

Answer 2

3 point pressure, hyperextension, show pressures

Question 3

what is your orthotic recommendation for a patient with an odontoid fracture who was just removed from a halo?

Answer 3

SOMI, extended philadelphia

Question 4

What is the major advantage of a SOMI orthosis?

Answer 4

can be fit to the patient supine

Question 5

Recommend an orthosisto control flexion and extension for a stable C-3 fracture?

Answer 5

4 poster, SOMI, 2 poster

Question 6

What is spondylolisthesis?

Answer 6

anterior slippage of L4 on L5 or L5 on S1

4 grades of slippage

Question 7

How would you orthotically treat spondylolisthesis?

Answer 7

BOB brace
Williams
Chair back
Corset

Question 8

A 47 year old male sustained L4 compression fracture during a fall. What is your orthotic recommendation?

Answer 8

BOB
Jewett
Chair back
Corset

Question 9

What is your orthotic recommendation for a 68 year old female with osteoporotic kyphosis?

Answer 9

Dorsal lumbar corset

Taylor

Question 10

How would you treat a fracture at T3?

Answer 10

body jacket with cervical extension

Question 11

Can you put a halo ring on a child

Answer 11

yes, less torque more pins

Question 12

Would you apply a halo vest to a patient in ICU without a doctor?

Answer 12

No, MD should be there to stabilize the neck

Question 13

For stable compression fractures of the cervical spine the head should be positioned in flexion or extension?

Answer 13

Extension

Question 14

Describe the orthotic treatment and RX rationale for burn patients.

Answer 14

Pressure garments, burn masks - to reduce hypertrophic scarring

Question 15

What is torticollis?

Answer 15

contracture of the sternocleidomastoid

Question 16

what is the recommended torque for halo pins in adults and children

Answer 16

adults - 8 in/lbs

children 4-6 in/lbs

Question 17

what is the reasoning behind using non-ferrous components in halo systems?

Answer 17

MRI compatible

Question 18

Halo pins are tightened in what fashion?

Answer 18

2 in/lbs alternating opposing diagonal forces until 6-8 in/lbs is reached.

Question 19

During anterior pin placement, should the patient have his eyes closed or open?

Answer 19

closed

Question 20

What tool would you use to apply halo pins

Answer 20

torque screwdriver

Question 21

The pins on a halo should be re-tightened at what time interval after initial application?

Answer 21

24-48 hours

Question 22

An inflamed pin site, pain at the pin site, noise or movement are indications of what?

Answer 22

Loose pin

Question 23

Your pain comes into your office with a loose pin. You try to re-tighten and no resistance is met. Your next step would be:

Answer 23

Call the dr.

Question 24

What are the advantages of using breakaway torque wrench?

Answer 24

wrench breaks off at set amount of toque. smaller in size for getting into cramped areas

Question 25

what 2 nerves could be compromised with incorrect positioning of the anterior pins?

Answer 25

supraorbital & supratrochlear nerves

Question 26

What is Risser Sign?

Answer 26

Method of determining bone maturity, using x-ray, reading the iliac epiphysis, graded 0-5

Question 27

what is the purpose of the neck ring on a Milwaukee?

Answer 27

the upper pressure point for high scoliosis curves or kyphosis - not a distractive force

Question 28

Why is the anterior bar of a milwaukee made of aluminum?

Answer 28

so that it is x-ray transparent

Question 29

What is the proper placement for a thoracic pad on a CTLSO?

Answer 29

2 ribs inferior to the apex of the curve, pad is "L" shaped

Question 30

Name and describe 2 other types of pads?

Answer 30

shoulder ring, lumbar (kidney shaped pad), anterior derotation

Question 31

What is proper clearance of the throat mold on a CTLSO?

Answer 31

2 finger (1") below the chin

Question 32

how long does a patient normally wear a scoliosis orthosis?

Answer 32

until skeletal maturity, then patient is "weaned" off the brace

Question 33

What is the most common type of scoliosis?

Answer 33

idiopathic, occurs most often in girls

Question 34

Do you treat functional & structural scoliosis the same?

Answer 34

No, functional curves are fit with corrective devices, structural curves are usually treated with an accommodative device

Question 35

What are the upper and lower limits, in degrees for treatment of scoliosis orthotically?

Answer 35

Current thinking is 25-40 & progressive

Question 36

At what spinal level would you consider using a CTLSO rather than a TLSO for scoliosis?

Answer 36

T6 - T8

Question 37

How do you determine which is the primary curve and which is compensatory?

Answer 37

the primary curve is the more structural, curve will always have rotation. compensator curves accommodate the primary to center the head over the pelvis