ORTHOSIS FOR THE CERVICAL SPINE.

Pain in the cervical region is, after low back pain, the most common reason for
visiting an Orthopedic clinic, and it is also one of the frequent causes for visiting
a general practitioner.
There are different types of orthoses worldwide as well as orthopedic devices
for this treatment.

Cervical collar : Orthosis whose objective is to reduce the mobility of the

cervical segment and relieve pain.

Indication:

1. Soft tissue trauma (Cervical Whiplash)

2. Mild bone trauma (Transverse spinous processes)
3. Rheumatic processes in the painful phase (Cervicobrachialgia)
4. Postoperative protection (Torticollis treated surgically)

For the manufacture of this type of Orthosis, it must be taken into account that it
prevents hyperextension, as well as flexion of the cervical spine, seeking a
neutral position of the head.

DIFFERENT TYPES OF COLLARS THAT EXIST

1. Soft Cervical Collar without support .

Technology: Constructed of polyurethane rubber foam covered with
a washable Stokinete cover and fastened with Velvro
on the back. 3 sizes are made.

2. Semi-rigid cervical collar without support .

Technology: Constructed of 2 overlapping pieces of polyethylene
adjustable in height, using velcro. 3 sizes are made.

3. Semi-rigid Cervical Collar with chin support . Technology:

Made with two overlapping pieces of polyethylene
Adjustable in height, using 2 front metal bars, their
position is fixed by screws.
 4. Semi-rigid Cervical Collar for Torticollis .
Technology: It has the same characteristics as the semi-rigid cervical collar
without support, only that its side parts are asymmetrical. Built
according to measurements.

5. Semi-rigid Cervical Collar with opcipitomental support .

(Philadelphia)
Technology : It is made with plastozote, from the plaster impression, it consists
of 2 pieces and is fastened with Velcro tape (3 sizes).

Biomechanics
The cervical spine supports the force of the center of
gravity that is in front of the junction of the cervical spine
with the head and the tensile force of the neck muscles.
When there is a cervical injury, the muscles in the neck
contract, producing an overload on the intervertebral
discs, causing pain to increase.
The function of the collar is to reduce this pressure on
the intervertebral discs, causing pain to decrease;
occipitomental orthoses are more effective.

The orthoses are worn 24 hours a day, or removed at night.

Should not compress the glottis
There must be a neutral position of the head, do not apply with
flexion or hyperextension.
Maintain the hygiene of the device.
CTOs significantly reduce the mobility of the middle and lower cervical spine due to the incorporation of the
trunk, but they cause great discomfort to the patient.

Cervical Minerva
Orthosis whose purpose is to suppress the mobility of the cervical spine to
relieve pain.

Indications:
1. Major trauma. (Fractures and dislocations)
2. Postoperative protection (herniated discs)
3. Bone metastases (Tumors)
4. They are especially indicated in injuries of the upper cervical spine (C1
and C2)

For its manufacture it is important to have the following points as reference:

• Center of the chin
• Suprasternal fossa
 • Contour of both collarbones
• Spinous apophysis.

DIFFERENT TYPES OF EXISTING MINERVAS.

1. Plastic Minerva (Acrylic )

Technology: It is made from two pieces thermomolded in molds, its fastening
is with straps (3 sizes)

2. 4 post Minerva .
Technology: Opcipitomental Support (plastic or metal), 6 metal
bars and 4 special buttons. Fastening with 6 straps.

3. Metallic Minerva .
Technology: Its construction is similar to the previous one, only
that it is fastened with 4 straps
4. Minerva type Somy .
Technology: It is made with light, moldable metal material, for occipitomental
supports, fastening by straps. A type of helmet can be added to
achieve better immobilization and all its supports can be adjusted.

5. Cervicothoracic Minerva .
Technology : It is made of metal and plastic and its fastening is through straps
very similar to the previous one.

As other variants for the treatment of the cervical region, there are other types
of equipment or devices that are:

Cervical traction devices.

Mechanical equipment to perform traction of the cervical spine.

Indications:
1. Osteoarthritis
2. Cervicobrachialgia
3. Inflammatory processes that cause muscle contracture
4. As a complement to other treatments.

Vertical cervical traction devices.

Horizontal cervical traction devices. (in bed).
Traction can be applied continuously or intermittently and in a vertical or
horizontal position. Continuous traction causes a distraction of the cervical
spine, reducing the pressure on intervertebral discs and opening the
conjunction foramina, which reduces compression on the nerve roots. As a
result, muscle spasm and pain are relieved.
Horizontal traction apparatus (in bed) properly installed with a
45° angle allows it to be easily maintained in successive sessions. However,
with the vertical traction device the angle can vary, since the patient can sit
each time at a different distance from the base of the traction axis.
In both cases, they are equipment especially indicated for people who, for
different reasons, have difficulty moving.

Cervical pillow

Function: Relax the cervical muscles during hours of rest, thereby reducing
pressure on the
nerve roots.

Indications:
• Complementary treatment method
• Cervical disorders.
These devices constitute an effective aid in the treatment of cervical spine
processes and can be used as a prophylactic method, to prevent disorders in
the cervical area, especially in certain professions that suffer from mechanical
overload of this area.

There are 2 types of cervical pillows: cylindrical pillow and anatomical pillow, the
latter being much more effective