Overview of Spinal Orthoses Flashcards
(40 cards)
Biomechanical Principles
Kinesthetic reminder
↑ Intra-abdominal pressure
3-point force system
Spinal alignment support
The Extrinsic stability comes from
the muscles in and around the back and abdomen
Intrinsic Stability comes from
the fluid workings of the ligaments and discs
While the ligaments provide not only a linkage between vertebrae, they also transfer of some of the axial load of the spine as well as assist to smooth the motion between various linkages.
Off-the-Shelf (OTS)
Think: Grab-and-Go
Pre-made in standard sizes (S, M, L, XL, etc.)
No modifications required
Quick solution for acute or temporary use
Typically lower cost
Examples: soft collars, basic lumbar braces
✅ Pros: Convenient, inexpensive
❌ Cons: Limited fit, not ideal for complex needs
Custom Fit
Think: Pre-made, then tweaked
Prefabricated device that is adjusted to fit the patient
Can include straps, trimming, padding adjustments
Often used post-operatively or for moderate stabilization needs
Examples: TLSOs molded to a general shape then heat-molded for better fit
✅ Pros: Better fit than OTS, faster than full custom
❌ Cons: Limited to available base shapes/sizes
Custom Fabricated
Think: Made-from-scratch for you
Fully individualized: designed and built based on a cast or 3D scan
Used for long-term or complex cases
Most durable and supportive
Required for spinal deformities, scoliosis, high-risk post-op care
✅ Pros: Best fit and support, durable
❌ Cons: Expensive, takes longer to fabricate
CO
Cervical Orthosis
CTO
Cervico-Thoracic Orthosis
TLSO
Thoraco-Lumbo-Sacral Orthosis
LSO
Lumbo-Sacral Orthosis
SIO
Sacro-Iliac Orthosis
Flexible:
Made of soft materials (e.g., corsets, belts)
Allow more motion; used for mild support.
Semi-rigid:
Combine soft materials with rigid stays or panels.
Rigid:
Typically made from molded plastic or metal; restrict motion significantly (e.g., Milwaukee brace, Boston brace).
CERVICAL ORTHOSES (COs) - types
Foam Collars – Soft, minimal support
Reinforced Collars – Moderate support (e.g., Philly, Aspen, Miami J)
Rigid Collars – Max support:
2-post
4-post
Foam Collars
Description: Soft, flexible; minimal restriction
Indications: Mild whiplash, soft tissue strain, comfort/support
Contraindications: Instability, fracture, need for immobilization
Reinforced Collars (Philly, Aspen, Miami J)
Description: Semi-rigid plastic collars with chin and occiput support
Indications: Moderate soft tissue injury, post-op support, stable fractures
Contraindications: High cervical instability, poor skin integrity
Rigid Collars (2-post, 4-post)
Description: Hard plastic + metal, posts to thorax or headpiece
Indications: Cervical instability, fracture, trauma
Contraindications: Severe skin issues, inability to tolerate rigid bracing
CERVICO-THORACIC ORTHOSES (CTOs) - types
SOMI
MINERVA
HALO
SOMI (Sternal Occipital Mandibular Immobilizer)
Description: Semi-rigid anterior chest support with head straps
Indications: Upper cervical spine injuries (C1–C5), post-op fusion
Contraindications: Lower cervical injuries, thoracic instability
Minerva
Description: Molded CTO with chest, back, and occipital support
Indications: C1–T3 stabilization, non-invasive HALO alternative
Contraindications: Unstable skull/cranial anatomy
HALO
Description: External fixation with skull pins, thoracic vest
Indications: Maximum immobilization for cervical fractures (C1–C2)
Contraindications: Skull fractures, infection at pin sites
LUMBOSACRAL ORTHOSES (LSOs) - types
corset
chairback
knight
williams-flexion brace
Corset
Description: Fabric with stays, flexible support
Indications: Low back pain, muscle strain, pregnancy
Contraindications: Fractures requiring rigid immobilization
