Spinal Orthotics Oral Questions Flashcards
Name 3 ways to manage a T11 anterior compression fracture orthotically?
- Jewett
- Taylor (dorsal lumbar)
- Body jacket
What is the biomechanical principle of a Jewett brace?
*3 point pressure
*Hyperextension
*Show pressures
What is your orthotic recommendation for a patient with an odontoid fracture who was just removed from a halo?
*SOMI
*Extended Philadelphia
What is the major advantage of a SOMI orthosis?
Can be fit on supine patient
Recommend an orthosis to control flexion and extension for a stable C3 fracture?
*Four poster
*SOMI
*Two poster
What is spondylolisthesis?
Anterior slippage of L4 on L5 or L5 on S1 (4 grades of slippage)
How would you orthotically treat spondylolisthesis?
*BOB brace
*Williams
*Raney flexion jacket
A 47 year old male sustained an L4 compression fracture during a fall. What is your orthotic recommendation?
*BOB
*Jewitt
*Chairback
*Corset
What is your orthotic recommendation for a 68 year old female with osteoporotic kyphosis?
*Dorsal lumbar corset
*Taylor
How would you treat a fracture at T3?
Body jacket with a cervical extension
Can you put a halo ring on a child?
Yes, less torque more pins
Would you apply a halo vest to a patient in ICU without a doctor?
No, doctor should be there to stabilize the neck
For stable compression fractures of the cervical spine the head should be positioned in flexion or extension?
Extension
Describe the orthtoic treatment and RX rational for burn patients
Pressure garments, burn masks – to reduce hypertrophic scarring
What is torticollis?
Contracture of the sterno-cleido-mastoid muscle
What is the recommended torque for halo pins in adults and in children?
Adults: 8 inch pounds
Children: 4-6 inch pounds
What is the reasoning behind using the non-ferrous components in halo systems?
MRI compatible
Halo pins are tightened in what fashion?
2 in/lbs alternating opposing diagonal forces until 6-8 in/lbs is reached
During anterior pin placement, should the patient have his/her eyes open or closed?
closed
what tool would you use to apply halo pins?
Torque screwdriver
The pins on a halo should be re-tightened at what time interval after initial appliation?
48 hours
An inflamed pin-site, noise or movement are indications of what?
Loose pin
What are the advantages of using a breakaway torque wrench?
Wrench brakes off at set amount of torque. Smaller in size for getting into cramped areas
What two nerves could be compromised with incorrect positioning of the anterior pins?
Supraorbital and Supratrochlear nerves
What is Risser sign?
Method of determining bone maturity, using x-ray, reading the iliac epiphysis, graded 0-5
What is the purpose of the neck ring on a Milwaukee?
The upper pressure point for high scoliotic curves or kyphosis – not a distractive force
Why is the anterior bar of a Milwaukee made of aluminum?
So that it is x-ray transparent
What is the proper placement for a thoracic pad on a CTLSO?
Two ribs inferior to the apex of the curve, pad is “L” shaped
Name and describe two other types of pads?
*Shoulder ring
*Lumbar (kidney shape pad)
*Anterior derotation
What is proper clearance of the throat mold on a CTLSO?
Two fingers (1”) below the chin
How long does a patient normally wear a scoliosis orthosis?
Until skeletal maturity, then patient is “weaned” off the brace
What is the most common type of scoliosis?
Idiopathic, occurs most often in girls
Do you treat functional and structural scoliosis the same?
No, functional curves are fit with corrective devices, structural curves are usually treated with an accommodative device
What are the upper and lower limits, in degrees for treatment of scoliosis orthotically?
Current thinking is 25-40 degrees and progressive
At what spinal level would you consider using a CTSLO rather than a TLSO for scoliosis?
T6-T8
How do you determine which is the primary curve and which is compensatory?
The primary curve is the more structural, curve will always have rotation. Compensatory curves accommodates the primary to center the head over the pelvis
