General Description - Cervical Orthoses (CO) Print

1. Introduction - Cervical Orthoses (CO)

Several drawbacks to CO use have been noted, as follows :

  • The soft-tissue structures around the neck (eg, blood vessels, esophagus, trachea) limit the application of aggressive external force.
  • The high level of mobility at all segments of the cervical spine makes it difficult to restrict motion.
  • Cervical orthoses offer no control for the head or thorax; therefore, motion restriction is minimal.5 (Cervical orthoses serve as a kinesthetic reminder to limit neck movement.)

Appropriate precautions associated with orthotic use should be observed. It should be kept in mind that the long-term use of orthoses has been associated with decreased muscle function and dependency.

The soft collar (see below) is a common, lightweight orthotic device made of polyurethane foam rubber with a stockinette cover; Velcro closure straps are used for easy donning and doffing. Patients find the collar comfortable to wear, but it is easily soiled with long-term use. The average soft collar costs $50.

Soft collar.
Soft collar.

Indications for the use of a soft collar include the following benefits for the patient:

  • Warmth
  • Psychological comfort
  • Head support when acute neck pain occurs
  • Relief from minor muscle spasm associated with spondylolysis
  • Relief from cervical strain

The soft collar provides some motion limitations for the patient, including the following:

  • Full flexion and extension are limited by 5-15%.
  • Full lateral bending is limited by 5-10%.
  • Full rotation is limited by 10-17%.

Hard cervical collars are similar in shape to soft collars but are made of Plastizote, a rigid polyethylene material. Hard collars are ring-shaped with padding; some of these have an adjustable height, providing patients with a better fit. Velcro straps are used for easy donning and doffing. With regard to long-term use, hard collars, which cost approximately $60, are more durable than soft collars.

Several problems can be alleviated with the use of a hard collar. Indications for the orthosis include the following:

  • Head support when acute neck pain occurs
  • Relief of minor muscle spasm associated with spondylosis
  • Psychological comfort
  • Interim stability and protection during halo application

Motion restrictions associated with the hard collar include the following:

  • Full flexion and extension are limited by 20-25%.
  • The hard collar is less effective in restricting rotation and lateral bending.
  • It is better than a soft collar in motion restriction.

article reference: http://emedicine.medscape.com/article/314921-overview