Flashcards in Spinal Orthotic Biomechanics Deck (33)
A 20 year old male has sustained an L1 burst fracture - What do you recommend?
TLSO: Triplanar control
Which orthosis would be indicated for a T9, 2-column compression fracture?
TLSO: sagittal/coronal control
Which orthosis would you recommend to manage an anterior compression fracture at T12?
TLSO: sagittal control
A patient presents with disruption of the supraspinous ligament, posterior longitudinal ligament and the ligamentun flavum. What is most likely the mechanism of injury?
When the anterior longitudinal ligament is involved, what is the most common mechanism of injury?
The correct anterior pin placement for a HALO is:
10mm superior to the eyebrow and placed above the lateral 1/3 of eyebrow
An adolescent female with scoliosis presents in your facility. Because she is being recommended for orthotic treatment, what presentation would you expect to see?
Risser sign of +1-2, Cobb angle of 25-40 degrees
Orthotic management of a T1 fracture should be treated with:
What is the correct posterior trim line for a thermoplastic TLSO?
10 mm distal to spine of the scapula
10 mm above the seat with hips flexed to 90 degrees
Which biomechanical principle would be the most effective in unloading an intervertebral disc?
Increased intra-cavitary pressure
List, in order from least to most effective, the following cervical orthoses: SOMI, 4-poster CTO, Miami J, HALO and soft collar
Soft collar, Miami J, SOMI, 4 poster CTO and HALO
Which condition should be positioned in sagittal flexion for orthotic treatment?
Spondylolisthesis, Spondylolysis and Spinal Stenosis
When is it acceptable to have the aterior apron on a conventional LSO to be shorter than the desired height?
Spondylolysis, Spondylolisthesis, or any condition that you treat with sagittal flexion
Unilateral contracture of the sternocleidomastoid that is indicative of torticollis would cause the patient to present with:
Lateral head flexion to ipsolateral side and rotation to the contralateral side
Placement of a thoracic band on a conventional LSO should be:
10mm distal to inferior angle of the scapula
What is the most important biomechanical principle when managing a neuromuscular spine?
Why is a SOMI not effective in controlling cervical extension?
The occipital pad pivots in the sagittal plane and the design does not have enough rigidity to control cervical extension
Can a three-column, two level injury be treated orthotically?
No, surgical stabilization will be needed prior to orthotic treatment
Traumatic spondylolisthesis of C2 is known as:
In what order should the HALO pins be tightened?
Diagonally opposed pins will be tightened together
Increasing the intra-abdominal pressure is used in spinal orthotics to:
Reduce axial load on lumbar vertebrae and intervertebral discs
What is the method used to find baseline for corset measurement?
(inferior costal margin to iliac crest)/2
If a patient is unable to tolerate strap pressure in the axilla in a TLSO:sagittal control orthosis, what adjustment might be done?
Use a harness chest strap with a sternal plate
Which cervical level exhibits the most sagittal motion?
The most motion occurs between the skull and C1
The Knight orthosis is also known as:
LSO: sagittal/coronal control
In what position should spinal orthoses be tightened on a patient?
Where is the appropriate placement of the paraspinal bars for lumbosacral orthosis?
Follow the apices of the paraspinal muscles
Why would a Milwaukee CTLSO not be recommended for a person with a paralytic spine?
Due to the lack of sensation, the individual cannot provide the active forces (kinesthetic reminder) necessary for correction
Hypokyphosis is defined as having a sagittal curve magnitude in the range of:
A 35 year old male is seen at the hospital with a compression fracture of L5. What is your treatmet recommendation?
LSO with unilateral hip spica attachment
Due to the increase motion that would occur with stabilizing L1-5, the hip spica is added to immobilize L5 for the fracture to heal without irritation.
What is the most likely mechanism of injury for a seatbelt (chance) fracture?
Flexion and distraction
Which is the only orthosis known to control motion at the atlanto-occipital joint?