Spinal Orthotics Oral Questions

Question 1

Name 3 ways to manage a T11 anterior compression fracture orthotically?

Answer 1

1. Jewett
2. Taylor (dorsal lumbar)
3. Body jacket

Question 2

What is the biomechanical principle of a Jewett brace?

Answer 2

*3 point pressure
*Hyperextension
*Show pressures

Question 3

What is your orthotic recommendation for a patient with an odontoid fracture who was just removed from a halo?

Answer 3

*SOMI
*Extended Philadelphia

Question 4

What is the major advantage of a SOMI orthosis?

Answer 4

Can be fit on supine patient

Question 5

Recommend an orthosis to control flexion and extension for a stable C3 fracture?

Answer 5

*Four poster
*SOMI
*Two poster

Question 6

What is spondylolisthesis?

Answer 6

Anterior slippage of L4 on L5 or L5 on S1 (4 grades of slippage)

Question 7

How would you orthotically treat spondylolisthesis?

Answer 7

*BOB brace
*Williams
*Raney flexion jacket

Question 8

A 47 year old male sustained an L4 compression fracture during a fall. What is your orthotic recommendation?

Answer 8

*BOB
*Jewitt
*Chairback
*Corset

Question 9

What is your orthotic recommendation for a 68 year old female with osteoporotic kyphosis?

Answer 9

*Dorsal lumbar corset
*Taylor

Question 10

How would you treat a fracture at T3?

Answer 10

Body jacket with a cervical extension

Question 11

Can you put a halo ring on a child?

Answer 11

Yes, less torque more pins

Question 12

Would you apply a halo vest to a patient in ICU without a doctor?

Answer 12

No, doctor should be there to stabilize the neck

Question 13

For stable compression fractures of the cervical spine the head should be positioned in flexion or extension?

Answer 13

Extension

Question 14

Describe the orthtoic treatment and RX rational for burn patients

Answer 14

Pressure garments, burn masks – to reduce hypertrophic scarring

Question 15

What is torticollis?

Answer 15

Contracture of the sterno-cleido-mastoid muscle

Question 16

What is the recommended torque for halo pins in adults and in children?

Answer 16

Adults: 8 inch pounds
Children: 4-6 inch pounds

Question 17

What is the reasoning behind using the non-ferrous components in halo systems?

Answer 17

MRI compatible

Question 18

Halo pins are tightened in what fashion?

Answer 18

2 in/lbs alternating opposing diagonal forces until 6-8 in/lbs is reached

Question 19

During anterior pin placement, should the patient have his/her eyes open or closed?

Answer 19

closed

Question 20

what tool would you use to apply halo pins?

Answer 20

Torque screwdriver

Question 21

The pins on a halo should be re-tightened at what time interval after initial appliation?

Answer 21

48 hours

Question 22

An inflamed pin-site, noise or movement are indications of what?

Answer 22

Loose pin

Question 23

What are the advantages of using a breakaway torque wrench?

Answer 23

Wrench brakes off at set amount of torque. Smaller in size for getting into cramped areas

Question 24

What two nerves could be compromised with incorrect positioning of the anterior pins?

Answer 24

Supraorbital and Supratrochlear nerves

Question 25

What is Risser sign?

Answer 25

Method of determining bone maturity, using x-ray, reading the iliac epiphysis, graded 0-5

Question 26

What is the purpose of the neck ring on a Milwaukee?

Answer 26

The upper pressure point for high scoliotic curves or kyphosis -- not a distractive force

Question 27

Why is the anterior bar of a Milwaukee made of aluminum?

Answer 27

So that it is x-ray transparent

Question 28

What is the proper placement for a thoracic pad on a CTLSO?

Answer 28

Two ribs inferior to the apex of the curve, pad is "L" shaped

Question 29

Name and describe two other types of pads?

Answer 29

*Shoulder ring *Lumbar (kidney shape pad) *Anterior derotation

Question 30

What is proper clearance of the throat mold on a CTLSO?

Answer 30

Two fingers (1") below the chin

Question 31

How long does a patient normally wear a scoliosis orthosis?

Answer 31

Until skeletal maturity, then patient is "weaned" off the brace

Question 32

What is the most common type of scoliosis?

Answer 32

Idiopathic, occurs most often in girls

Question 33

Do you treat functional and structural scoliosis the same?

Answer 33

No, functional curves are fit with corrective devices, structural curves are usually treated with an accommodative device

Question 34

What are the upper and lower limits, in degrees for treatment of scoliosis orthotically?

Answer 34

Current thinking is 25-40 degrees and progressive

Question 35

At what spinal level would you consider using a CTSLO rather than a TLSO for scoliosis?

Answer 35

T6-T8

Question 36

How do you determine which is the primary curve and which is compensatory?

Answer 36

The primary curve is the more structural, curve will always have rotation. Compensatory curves accommodates the primary to center the head over the pelvis