Spine Orthoses Flashcards
what are the major functions of spinal orthoses?
– limit motion to:
– support _____
– ____ or _____ progression of deformity
– remind user to ____
– reduce pain, protect unstable segments, facilitate healing
– trunk/neck to reduce loads
– correct or limit
– maintain appropriate posture
soft spinal orthoses are made from:
– examples:
fabrics, elastics, neoprene
ex: corset, belts
rigid spinal orthoses are made from:
polyethylene or other plastics
effectiveness of spinal orthoses rely on: (3)
- points of application; at least 3 points, direction and magnitude forces
- device fit
- compliance!!
in order to correct a spinal deformity, the orthosis must have at least ____ points
three
front/back pieces control _____ plane
side plates control ______ plane
to control ______ plane, you need a 4 point pressure system
sagittal
frontal
transverse
what are some challenges to completely immobilize the spine with an orthoses?
- extremely mobile joint complex with multiple planes
- little body surface available for contact
** skin breakdown, pressure related pain, hygiene issues
what are negative effects of spinal orthoses? (4)
- axial muscle atrophy secondary to disuse
- immobilization –> contracture or ROM limitations
- skin breakdown –> excess pressure, irritation, and moisture
- psychological dependency
what is the normal spine motion in:
– Occiput-C1?
– C1-C2?
– C2-C7?
– ___ spine greater rotation than ___ spine
– flexion/extension
– rotation
– flexion/extension (C5-C7); side bending & rotation (C2-C3)
– Thoracic > Lumbar
Soft cervical orthosis:
prefabricated
– does not limit ____ spine motion
– ______ for providing protection or stabilization for acute and chronic whiplash or other mechanical disorders
– cervical
– ineffective
semi-rigid cervical orthosis:
prefabricated
– post trauma used to ___
– provide _____ but not rigid immobilization
—> better at controlling ____ movement
– stabilize the spine
– general support
—> sagittal ; control flexion better than extension
after anterior cervical discectomy and fusion, are cervical collars supported?
posterior approach?
NO! not supported for both
are cervical orthoses recommended after:
- whiplash?
- trauma?
no to both
CO use after cervical fractures:
– flexibility?
– _____ better at controlling ROM than ____ and ____
– semi-rigid
– NecLoc ; Philadelphia and Aspen Collars
what is the recommendation for CO use for patients with acute neck pain with radiating pain?
– what grade?
** must have sensory symptoms in the arm, limited & painful cervical ROM, & motor disturbances**
use of a cervical collar for pain reduction may be considered. The advice is use it sparingly: only for a short period per day and only for a few weeks
– Grade C/III
Complications with CO use:
- skin breakdown - increased risk associated with days in CO and edema
- limitations in swallowing, coughing, breathing and vomiting - could cause aspiration
- general immobility
- increase intracranial pressure
- psychological dependence
what does a CTO do?
- provide greater restriction of segmental and regional motion, particularly of lower cervical spine
compared to COs, CTOs are more effective at _____
controlling frontal plane and transverse plane motion
Post-Type CTO:
– more _____ and cooler than collar
– more difficult to ____
– two and four-post control _____ well
– four post better at controlling ____ and ____ plane motion
– restrictive
– don/doff
– flex/ext
– frontal and transverse
Sternal Occipital Mandibular Immobilizer (SOMI):
– ___ post
– no ____ ____ plate –> more comfortable laying in supine
– indicated for those with instability at or above ____
– three
– posterior thoracic
– C4
SOMI is most effective at controlling ??
least effective ??
- flexion C1-C3
- extension
Four post CTO, Malibu collar with thoracic extension, and Yale CTO are collars used for ____
instability of C4 or below