• Diagnostic toos - a sx could use a very rigid body jacket to simulate a fusion
• Alternative to invasive techniques
• Augment to surgery - help facilitate teh healing process

What are some disadvantages to spinal orthoses

• Aesthetics - veryhard to hide a spinal brace
• Comfort - there is an element of heat retention and movment restriction

• Decreasing Pain
• Facilitating healing
• Correct or prevent deformity

• 3 point force
• End point control
• Increase intra-abdominal pressure
• Total contact
• Kinesthetic Reminder

CO - cervical orthoses are used

for what levels of  injury

[image]

C2 - C5

soft collar - soft tissue injuries, used mostly as a kinesthetic reminder

hard collar - used for fx's, nerve injury, maintaining good vertebral alighnment

CTOs - cervical-thoracic orthoses are used to manage what level of injuries?

[image]

C1 - T1

a longer lever arm can be added for increased control

CTLSO - cervical thoracic lumbosacral orthosis is used to manage injuries at what level?

[image]

T1 - S1

If T1 is involved you will need to add support at the cervical region to accommodate it, to add additional leverage

TLSOs - thoracic lumbosacral orthosis is used to manage what level of injuries?

[image]

T6 - S1

a body jacket/corset

LSO - lumbosacral orthosis is used to manage injuries at what level?

[image]

T11 - S1

** a hip spica is used when S1 is involved!

How are the control features classified on spinal orthoses, and what motions will they control?

• A - flexion control
• PL - extension control and lateral bending
• APL - controls flexion, extension, and lateral bending
• APLR - controls flexion, extension, lateral bending, and rotation
  • To get good rotational support the brace will need to come up to the deltoid groove at the shoulder girdle (the area where the deltoid blends into the pectoralis)

What are some of the main braces

sed to manage scoliosis and some

key points about each?

• Milwaukee - a neck ring - must be worn 24 hrs/day
• Charleston - a nighttime brace worn by most kids w/ scoliosis
• Boston - to be worn 24 hrs/day, more low profile and comfortable

With all of the braces pt compliance is huge for the correction of the deformity!

When will the decision be made to begin bracing for a patient with scoliosis, and at what level is the decision for surgery made?

once the curve magnitude

reaches 25 degrees bracing will begin

after a 45 degree curve magnitude

surgery may be performed

When can a patient with

scoliosis stop wearing the brace?

• Plagiocephaly - flat head babies
• To manage - a plastic helmet will be used to re-shape the head, the helmet is made w/ a pocket or a void over the flat shap
• This must be done before 18 months of age

• Put on in supine
• Use the log roll technique, have them bend their knees and move the upper torso in one motion
• If a lift team is available this is most effective

• Miami J collar
• Philadelphia collar
• Thomas collar

APL control TLSO

How should a patient donn an

orthosis after surgery?

• Three point force system
• Kinesthetic reminder

What orthosis is effective in

controlling an injury at T1 level?

• Rigid cervical orthosis with thoracic extension
• TLSO body jacket with cercical extension
• CTO