Spinal Braces

Braces

 

1.  Motion Control

 

2.  Spinal Realignment

 

3.  Trunk Support

 

4. Weight Transfer

 

Soft Collar

 

Cheap & Comfortable

- ineffective

- allows 70% Flexion Extension / 80% Rotation / 90% Lateral bend

 

Philadelphia Collar

 

Better than soft collar but less comfortable

- allows 35% Flexion Extension / 40% Rotation / 60% Lateral bend

- excellent immobility in acute situation when combined with sandbags & forehead tape

 

SOMI Brace

 

Sterno-Occipital Mandibular Immobilizer

- effective control C1/2 & C2/3

- allows 30% Flexion Extension / 30% Rotation / 60% Lateral bend

 

Yale Brace

 

Cervico-Thoracic Brace

- Philadelphia Collar but with chest extension & strap 

- best of conventional braces

- allows 10% Flexion Extension / 50% Rotation / 25% Lateral bend

 

HTB / Halo-Thoracic Brace

 

Best overall but highest complications

- 4 % Flexion Extension

- 1 % Rotation

- 1 % Lateral bend

 

HTB Xray

 

Application

- roll patient on side in controlled manner

- fit posterior chest brace

- roll back, apply anterior chest brace, tighten

- size halo

- should have 1 - 2 cm gap from skull

- sits 1 cm above pinna and eyebrows

- 4 pins

- 2 above pinna, 2 above upper and outer eyebrow

- must miss supra-orbital nerve

- can shine torch through holes to mark sites of pins

- LA to sites

- must close eyes before supraorbital pins to avoid problems closing eyes

- tighten to 8 pounds / SI

- often come with snap lock pins

 

Infection

- use oral antibiotics

- may need to remove pins

 

Gardner Wells Tongs

 

Used to obtain and maintain reduction

 

Graphite / MRI compatible available

 

Insertion sites as per HTB

 

Thoraco - Lumbar Orthosis / TLSO

 

Types of TL Orthosis

1. TLSO

2. Three point brace

3. Moulded Body Jacket

 

CTLSO / Milwaukee

 

TLSO with neck brace

 

For lesion with apex above T8