Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 7

What Are The Different Kinds of CTOs?

Different kinds of CTOs exist today. Some are prefabricated and others are custom made. Typically, with a custom made brace, a cast and measurements are required. This process will take about an hour, unless an orthotist (brace specialist) can get a very good cast of the patient using fiberglass material. This will mean that the patient has to be cast in a position where the orthotist can do a circumferential wrap of the patient's head, neck and body in a sitting or standing position.

Where Do You Get a CTO?

Daily Care and Hygiene Measures To Consider When Using A CTO

A proper program of hygiene will help to prevent skin problems or pressure sores. Although the brace may fit you well, it is possible to sit in an unbalanced position from time to time and this can make the brace fit differently. - If your CTO is dirty, it should be washed inside with mild soap and water. Make sure your skin is clean when you apply the CTO as well. Perspiration will occur if you wear this brace long enough and cleaning everything is a good idea.

Special Instructions To Those Individuals Helping a Patient With Their CTO

1.) Avoid using powers or lotions on the patient's skin, where the CTO will be applied. Although you may be trying to help the patient, these things can soften the skin and cause skin breakdown in conjunction with a brace.

2.) If the skin is red or ulcerated, call the orthotist who provided you with the brace. They can pad the area around an ulcer or sore spot of skin to help create a relief in many instances.

3.) Patients who need moderate to maximum assistance will need to be continuously observed when it comes to the position of their CTO. Monitor the position of the chin and the position of the shoulder aspects of the brace to ensure a proper fit.

4.) The brace should always be worn snug, not loose. If the brace is worn loosely it will allow movement of the spine and this could be severely problematic for the patient.

5.) Whenever the patient is moved, either from the bed to another location, check the position of the CTO. It is important that there is not excess gapping over the shoulders or under the chin.

Insurance and CTOs

One of the extra benefits of working with a licensed orthotist at an "O & P" (orthotics and prosthetics) company is that they can help bill your insurance for this brace or any other orthopedic braces. Many times these kinds of braces are covered by insurance. If it is not completely covered, many times a good portion of the orthosis (orthopedic brace) is covered, decreasing your amount of out of pocket expense.

Note: This is health information. Medical advice regarding braces should be provided to you from your local, licensed and providing orthotist. This information can be helpful, of course, but it is best to get medical advice on bracing from these local brace specialists.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 8

Can I just use a rigid collar instead of a CTO?

There are times when a cervical collar can be worn in place of a CTO while a patient is in bed. This is not always the case. Depending on the recommendation of your physician, you will know when you can use a rigid collar and when you have to use a CTO.

How Do I Know When I Need A CTO?

This kind of brace is usually chosen by your physician. It is usually chosen by a neurosurgeon or orthopedic physician, in most cases.

When to Call the Doctor With Respect to Your Brace

If you experience:

1.) Numbess or Tingling
2.) Weakness of your arms or legs
3.) Pain
4.) Incisional drainage

Halo

What is a Halo?

A halo is considered to be a cervical device that locks out motion in all 3 planes. In other words, a halo that is properly applied will inhibit coronal, transverse and sagittal planes of movement. This is a brace that the patient should not try to remove by themselves. Other braces can be removed by a patient, but this is not one of them. It should stay intact as long as the patient is in danger of furthering their cervical injury level. Usually, these braces are used for people that have an unstable cervical fracture that is located in the C1 or C2 region.

Who Uses a Halo?

Halos are used for patients that have unstable cervical fractures. When a person has this kind of a fracture, neurological compromise can quickly occur.

When Puts A Halo on For Patients

The truth is that a patient is not supposed to put on their own halo. This is a device that is applied by physicians and orthotists (brace professionals). You will find that a halo is applied by these individuals and should not come off until your are healed.

How Long Do I Wear A Halo For?

The healing process for a neck injury that requires a halo is usually about 8-12 weeks. On occasion, patient's may go into surgery with a halo on and come out of surgery with it off. This means that their stability level increased due to the surgery, to the point where a halo is no longer needed. After the halo is removed, your physician may want you to wean into a cervical collar, either rigid or soft in design.

Note: This is health information. Medical advice on bracing should be provided to you from your local, licensed orthotist.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 5

How Do You Know A Rigid Collar is On Correctly?

Each collar is made differently, but there are some overall rules of thumb that can apply to all collars.

Snug Fit and Chin Position

First, it is important to always wear a brace snug, never loose. This includes the use of a "rigid cervical collar". This ties into the position of a cervical collar as well. With many cervical collars that are available today, it is important that you can see the patient's chin, when they have the brace on. If a person has on a neck brace and their chin is tucked inside of the cervical collar, chances are that the brace is not doing what it is designed to do. You do not want to see a patient's bottom lip first when you look at them, while they have a cervical orthosis donned. Unless the brace is the incorrect size, or made improperly, (which should not be the case if a licensed orthotist provided it), then you should always be seeing the patient's chin when they have the brace on.

The Words on The Brace, Why Its Important To Look From Outside The Brace

Almost any brace that is provided today is designed so that other individuals (besides the patient) can look at the collar and read the words on it the right way up. Remember that the manufacturer does not want to be forgotten about. After all, they have spent a lot of time manufacturing this product and they are proud of their work. Therefore, if an "outside" individual, who is looking at at the brace, can not read the writing then something is usually wrong. If the person looking at the collar can not read the words correctly, then it is quite possibly on upside down.

Arrows Located On The Brace

Lastly, if there are any arrows on the collar, they are usually meant to point upward when the brace is on as well. These are the arrows that the manufacturer put on the brace. - This general example applies to any brace that you see a patient wear. If you have any questions about the fit and function of your current collar, then it is wise to communicate with your providing brace specialist for more information.

*Note: This is health information. When it is time to get personal, medical advice on bracing, then it is best to speak with your local, licensed orthotist on the subject. This is good information, but this is not medical advice.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 2

How do you know when a soft collar is fitting correctly?

This is a very good question because many times these braces are fit incorrectly. A brace, no matter if it is a collar or another type of orthosis (brace), needs to be applied in a "snug" fashion. Well, what does "snug" really mean, right? - Snug, usually means that the brace has been applied in a way that it is comfortable, without gapping, and without a restriction on breathing when it comes to cervical collars. If an orthosis is worn loosely, it will not do a patient any good. Plain and simple.

The cervical spine needs to be supported when weakness or instability is present. A soft collar will help a patient in this manner by supporting the chin and remainder of the mandible (jaw). If a person every dips their chin inward and down, the collar is probably not doing what it is designed for. In addition, if a soft collar has the velcro attachment placed in the front, it is probably not on correctly either. You will always have to allow for the brand that does attach in the front, but typically these collars attach in the back.

Skin Precautions With A Soft Collar

Monitoring your skin with any brace is also very important. In the vast majority of cases, people will not have skin problems, but it is best to be proactive and monitor your skin anyways. The main reasons why people's skin suffers in any brace is that the brace is not kept clean. This is important for people because a patient will probably have to wear a brace for at least a few weeks, so cleanliness of the collar and patient's skin does come into play.

In addition, individuals that are not alert can suffer from skin irritation as well. Or, if someone has a lack of sensation, then redness can develop in conjunction with a brace. Why is this the case? - The patient may not always be alert enough to monitor the way the brace is feeling or their body is not giving them proper feedback. If redness appears, then you need to contact your brace provider for a possible adjustment on the collar.

Note: This is health information. If you want medical advice on bracing, it is best to speak with a local, licensed orthotist. This is good information, but it is best to see someone locally for your particular bracing needs.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 4

Who Uses a Rigid Collar?

Someone that needs motion control in their cervical spine. In comparison to the soft collar, rigid cervical orthoses (braces) are used for more serious conditions. Yes, they are more supportive than a soft collar, but rigid collars are still not considered to be a the cervical brace that provides optimum cervical spine control. The CTO (cervical thoracic orthosis) and Halo can inhibit more movement than a rigid collar. The CTO and Halo need to be considered when motion control is a must and a clear understanding of the diagnosis will help to determine when each brace is needed. When instability is at a critical level, a CTO and Halo need to be considered.

What Are The Different Brand Names of Rigid Collars?

Common brand names you may hear of are the Atlas, Aspen, PMT and Miami J cervical collars. The purposes of this article, we are not going to comment on which rigid collar is better than the next, but these collars mentioned here are commonly used today in medical settings, on a daily basis.

Where Do You Get A Rigid Collar?

We recommend that you get a rigid cervical collar from a licensed orthotist in your area. Why? These individuals are brace specialists and can provide you with the most detailed information about your new orthopedic orthosis. These individuals are medically trained in the field of orthotics, which surrounds the field of orthopedic bracing. Nothing else gets focused on besides orthoses (braces) in this industry.

Other individuals that may work in hospitals may provide collars, but the best detailed advice regarding braces still lays in the hands of an orthotist, on a day to day basis. - We always use the example of your automobile, if you drive. (It is a general example that will get the point across more clearly for you.) If you own a car, and you wanted to get top notch service, wouldn't you take it to a specialist? Or, would anybody be qualified to do the work? - We think you know the answer for yourself. Why not do the same with orthopedic braces that you need for medical reasons. Your health is considered to be more important than that of your car, so why not treat a bracing scenario in the same way?

Note: This is health information. For medical advice on bracing, it is best to speak to with a local, licensed orthotist. When you need to get medical advice on your particular situation, then it is best to speak these individuals.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 3

Take Home Points For Medical Professionals Regarding Cervical Collars

Loosening a collar for a patient is not always the right action to take. The brace, no matter if it is a neck brace or any other type of orthosis, needs to be placed on the patient in a snug fashion. Unless the brace is somehow made wrong for the patient, a snug fit should not be a problem. Sometimes patients will turn to a medical professional or family member and ask for the brace to be loosened. This is all done without a bad intent and a gaurdian is happy to help the patient with this request. However, many times what this does is allow the brace to become more mobile. Then, can easily happen is the brace "migrates". As a result, the patient will have more problems with the brace in most cases. We all want the patient to be happy, but making a brace too loose can be a serious mistake. - Not only will the cervical collar be able to migrate, but it may also lose the support that it provides to the patient.

A Note on Skin Precautions & Cervical Bracing.

As a medical professional, it is important to monitor the fit of the brace for the patient, especially if you are in a setting where your patients are not entirely alert. You do not have to be an expert in the field of orthotics to notice some important things for the patient when it comes to bracing. For example, the patient's skin will tell you how the patient is feeling. If the patient can not consciously communicate with you in a verbal manner, then let their skin do the talking. If it is irritated, you will be able to know by looking at it.

When a patient is not entirely alert, like in an ICU situation, or they are heavily sedated, then this is when the skin irriation issues can come into play. Sometimes a patient will be in a position, in bed, that causes more problems with a brace and the patient does not even know it. That is where a health professional has to be aware and call the providing orthotist (brace specialist) when necessary.

Note: This is health information. Medical advice on bracing should be provided from your local, licensed orthotist. This is good information on bracing, but we say this because each bracing scenario is slightly different and we can not be held liable for each unique case.

Neck Braces, Rigid Collars, Cervical Orthoses - A Guide on Bracing The C-Spine - Part 6

CTO - Cervical Thoracic Orthosis - Their Function and Where To Get This Brace

What is a CTO?

The acronym stands for "cervical thoracic orthosis". As you will see with almost any acronym for bracing, the acronym starts with a letter that is closest to the head and distally (away from the head). You will see that this is the case for braces for the legs, arms and back.

The CTO is used to help support someone's cervical and thoracic spine. In specific, this orthosis (brace) is designed to support the cervical portion of the spine from C1 - C7. Sometimes to support a lower level of the cervical spine, however, you need to have the brace end lower than the injury level. - The CTO is designed to limit the motion of the cervical spine and skull, by stopping rotational movements and cervical capital flexion and extension.

What Does a CTO Do?

These orthopedic braces limit movement. More movement than that of a rigid collar. This is not necessarily a bad thing either. For example, after a surgery someone may need to be provided with this kind of orthosis to help act as an insurance policy for the surgeon's work. In other words, this orthosis (brace) will help to prevent a flexing or twisting movement that can ruin the surgical correction that was achieved. Typically, a rigid collar will extend down to a patient's clavicle area, where as a CTO will extend down to approximately the xyphoid process (or mid chest region).

A cervical thoracic orthosis can also be used for a fracture that has occurred in the superior portion of the thoracic spine (a high thoracic fracture) or a cervical fracture that is more serious in nature. - When you limit the motion at these segments, you improve upon the body's ability to heal itself. The brace does not heal you, but it does help to stop harmful movements that can easily occur at an injury level.

Who Are The People That Provide CTOs?

Today, many medical professionals can provide a cervical brace or a cervical thoracic orthosis. However, we believe that it is best to work with a local, licensed orthotist in your area when you get any type of orthopedic brace. Why? When a patient wears a CTO (whether it is custom or prefabricated) the person usually has a very serious diagnosis. A CTO is a special kind of brace which comes with a specific set of important instructions. This means that an orthotist should give you as much detailed information as possible when they provide the brace.

Note: This is health information, not medical advice. We believe that you can learn something from this information, but it is best to work with a licensed orthotist in your area for medical advice on bracing.