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Back Brace and Neck Collars for the Spine

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Senior with neck braceThe different braces and collars for the neck and back are known as spinal orthotics. The purpose of these devices are to limit movement of the spine thereby allowing it to heal. There are many different types of braces and collars for the spine but all have the same purpose. It can also help with posture and restoring the normal curvature and alignment of the spine. Although these devices are quite cumbersome and restrictive, it needs to be used when prescribed by a doctor or physical therapist to avoid more severe and permanent complications. In the elderly, these devices are commonly used for conditions scoliosis and kyphosis which are two disorders where the spinal curvature is abnormal due to various diseases.

Function of a Brace or Collar

In order to understand the importance of spinal orthotics, it is necessary to have a working knowledge of the structure and function of the back. There are 33 vertebral bones that are vertically aligned to compromise the backbone. This extends from the neck to the tailbone. The lower 8 to 9 bones are fused (five in the sacrum and three to four in the coccyx) and therefore lack the mobility of the upper parts of the spine. The bones that comprise the neck are known as the cervical vertebrae, those of the midback are the thoracic vertebrae, low back are the lumbar vertebrae and the buttock has the fused sacral and coccygeal bones.

Between the unfused bones lie a spongy disc known as the intervertebral discs. The spine is not straight and has a natural curvature that is somewhat S-shaped in the vertical alignment. It is very flexible due to the number of bones which articulate with the bones above and below it. The spinal cord runs within the vertebrae with nerves exiting from it at almost every vertebral level. These nerves relay signals back and forth between the brain and different parts of the body.

When there is any injury or disease of the spine, the highly flexible spine needs to be immobilized as movement may exacerbate the underlying spinal problem, prevent healing and even lead to serious complications. A neck collar or back brace being rigid, even with the soft types, allows for the spine to be immobilized even when walking around.

Therefore a brace or collar has the following functions :

  • Reduces pain.
  • Decreases abnormal sensations like pressure, tingling, pins and needles or numbness.
  • Improves strength, function of the spine and posture.
  • Corrects spinal deformities.
  • Minimizes spinal instability.
  • Reduce complications of back and nerve injury or deformity.
  • Eases tension on the muscles.
  • Helps with healing of ligaments and bones.

Types of Back Braces and Neck Collars

Both types of spinal orthotics, braces and collars, are available in a hard (rigid) or soft (flexible) form.

Cervical collars

cervical_collars

These collars provide support for the neck and head. It may be a soft or hard collar solely for neck support and minimal head support or head-neck orthoses for complete head and neck support. This category includes :

  • Philadelphia collar
  • Miami J collar
  • Malibu collar
  • Aspen collar
  • Jobst Vertebrace

Back braces

These braces may also provide support for the neck since the cervical vertebrae are part of the back bone.

Cervical Thoracic OrthosisCervicothoracic orthoses (CTOs)

These orthotic devices immobilize and support the cervical (neck) and thoracic (mid back) vertebrae. It includes :

  • Sternal-occipital-mandibular immobilizer (SOMI)
  • Yale brace
  • 4-poster brace
  • Guilford brace
  • Halo device

Thoracolumbar orthoses (TLOs)

TLO’s immobilize and provide support for the thoracic (mid back) and lumbar (lower back) vertebrae. It includes :

  • Cruciform anterior spinal hyperextension (CASH) brace
  • Jewett hyperextension brace
  • Korsain brace
  • Knight-Taylor brace
  • Thoracolumbosacral orthosis (TLSO) (clamshell)

Lumbosacral orthoses (LSOs)

LSOs immobilize and provide support for the lower back and buttock vertebrae. These types of devices include :

  • Chairback brace
  • Williams brace
  • MacAusland brace
  • Standard lumbosacral orthotic corset
  • Rigid LSO with or without hip spica

Scoliosis Braces

The spine normally curves inwards and outwards but is straight in terms of the horizontal alignment. If the spine curves sideways or away from the midline then this is known as scoliosis. It may also be treated with the use of a back brace. These braces include :

  • Milwaukee brace
  • Boston brace
  • Charleston bending brace

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