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bmsc orthotics > Spinal Orthotics > Flashcards

Spinal Orthotics Flashcards

1
Q

3 types of cervical/cervicothoraic orthoses

A

Collars
Poster-type
Halo- and Minerva-types

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2
Q

Describe a soft collar

A

Made from thermoplastic foam or rubber covered by cotton stocking. Degree of support provided depends on the compressibility of the material it is made from

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3
Q

Describe a firm collar

A

Pre-fabricated or custom made. Provide greater mandible and occipital support. More rigid therefore a more effective restraint than soft collars

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4
Q

Examples of firm collar devices

A

Supra-Lite and the Philadelphia collars

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5
Q

How does the Yale collar design differ

A

It has distal anterior and posterior extensions which increase control of cervical flexion and extension

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6
Q

Uses of collars

A

Whiplash
Arthritis
Stable bone/ligamentous injuries

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7
Q

Benefits of collars

A

Act as a reminder to self-restrict motion
Keeps the neck warm
Provides psychological support
Easy to fabricate at low cost

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8
Q

Disadvantages of collars

A

Only provide limited control over cervical motion

Limited head support

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9
Q

What are poster-type orthoses

A

Cervical/Cervicothoracic collars with 2 or more uprights that extend from the thoracic component to the occipital and mandible areas

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10
Q

What are poster-type orthoses used for

A

Stable bony/ligamentous/soft tissue injuries to the mid and lower cervical spine
May be used after removal of halo-top orthosis

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11
Q

Give an example of a 3-poster device

A

Sterno-occipital mandibular immobiliser (SOMI) brace

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12
Q

What restrictions does the SOMI impose

A

Most effective at resisting head flexion

Some resistance to head extension and lateral rotational control

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13
Q

Which movements are a 4 poster orthoses least effective at restraining

A

Head rotation: head can slide on the mandible and occipital pads
Lateral head movement: because some movement between the mandible and occipital pads can occur

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14
Q

Benefits of poster orthoses

A

Unlike collars, the neck is exposed which is desirable in the presence of wound/surgical incision sites on the neck

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15
Q

Describe a halo-top spinal orthosis

A

Rigid spinal orthosis that is attached firmly to the skull by screws above eye level, connected to the thoracic/thoracolumbar component by 4 rigid uprights

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16
Q

How does the Minerva-type spinal orthosis differ from the Halo-type

A

Has a rigid one-piece posterior section which connects the halo to the thoracic component
The rigid moulded ant. section extends to the chin

17
Q

What are Halo- or Minerva-type spinal orthoses used for

A

Unstable fractures of the cervical spine: they offer the greatest degree of constraint

18
Q

List some problems of wearing Halo-/Minerva- orthoses over a prolonged period of time

A

Skin irritation
Muscle atrophy
Joint stiffness
Psychological disorders

19
Q

What are the classifications used for orthoses other than cervical/cervicothoracic orthoses

A

Dynamic
Postural functional
Postural static

20
Q

When are dynamic spinal orthoses used

A

When correction of deformity/prevention of progression are required e.g. idiopathic scoliosis and adolescent kyphosis

21
Q

Aims of using dynamic spinal orthoses

A

Prevent progression of deformity
Minimise structural deformity
Prevent high compressive vertebral stress
Improve/maintain respiratory function

22
Q

How is the neck and head kept centred above the pelvis

A

Positioning of the pelvic and neck ring portions of the orthosis

23
Q

Give an example of a dynamic spinal orthosis

A

The Milwaukee CTLSO: 2 post. and 1 ant. metal uprights that connect the moulded pelvic girdle to the cervical ring around the neck. Thoracic and axillary pads attach to the uprights to correct scoliotic curves by 3-point loading

24
Q

How does the Scheuermann TLSO differ from the Milwaukee

A

Has lateroposterior thoracic panels to correct the spinal kyphosis

25
Q

Describe the Boston TLSO

A

Straight thermoplastic mould with corrective pads fixed to the inner surface

26
Q

When are postural functional spinal orthoses used

A 
Pathologies that require pain relief:
Kyphosis from senile osteoporosis
Prolapsed IV discs
Lower back pain
Sciatica
Ank spon
27
Q

Objectives of postural functional orthoses

A

Reduce vertebral motion/deformity

Prevent pain

28
Q

Give examples of postural functional orthoses

A

Jewitt TLSO, Jones TLSO and Raney flexion brace

29
Q

Describe a Jewitt TLSO

A

Anterolateral torso frame with rotating sternal pad, rigid suprapubic pad and a thoracolumbar strap and pad
Primarily controls flexion

30
Q

Describe the Raney flexion brace

A

A rigid plastic shell which completely surrounds the trunk. An indented region creates abdo compression

31
Q

What is the Raney flexion brace prescribed for

A

Lumbar sprain
Acute sciatica
Recurrent/post-op back pain

32
Q

Disadvantages of Raney flexion brace

A

Uncomfortable to wear

Not suitable for patients who cant tolerate increased abdo pressure

33
Q

What are postural static spinal orthoses used for

A

Pathologies caused by neuromuscular deficiency
Prevent further deformity rather than correcting it
E.g. spinal muscle atrophy, DMD, cerebral palsy and polio

34
Q

How to postural static spinal orthoses support mass loads

A

Apply principle of Total Contact: maximise surface area contact to the wearers body

35
Q

What are some problems with postural static spinal orthoses

A

Reduction in forced vital capacity

36
Q

Give 2 examples of postural static orthoses

A

Calot TLSO

Boston Overlap Orthosis

37
Q

Describe a Boston overlap orthosis

A 
Rigid thermoplastic module with ant. positioned straps
Restrains sagittal and coronal lumbar movement

bmsc orthotics (5 decks)

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