TY - JOUR
T1 - The stabilizing effects of different orthoses in the intact and unstable upper cervical spine
T2 - A cadaver study
AU - Richter, Dirk
AU - Latta, Loren L.
AU - Milne, Edward L.
AU - Varkarakis, George M.
AU - Biedermann, Lutz
AU - Ekkernkamp, Axel
AU - Ostermann, Peter A.W.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2001
Y1 - 2001
N2 - Background: Although cervical orthoses are frequently used in prehospital stabilization and in the definitive treatment for lesions of the cervical spine, there is little information about the control of extension-flexion, lateral bending, and rotation given to individual segments by different designs. Methods: In an experimental in vitro study with four fresh frozen cadavers, the halo vest was compared with the soft collar, prefabricated Minerva brace, and Miami J collar. The controlling effects for the segments C1-2 and C2-3 were tested for all four devices in the intact and the unstable spine with an Anderson type II fracture of the odontoid. Results: All four orthoses reduced the range of motion at both C1-2 and C2-3 of the intact spine significantly, although none of the three semirigid devices provided a halo-like immobilization in the intact spine. The osteotomy of the odontoid increased the range of motion in the segment C1-2. The soft collar did not give any clinically relevant stability to the unstable spine. Miami J and Minerva brace provided a similar moderate control in the sagittal plane but a much better control of "torque" in the upper cervical spine. The halo vest did not allow any measurable motion in any plane with our experimental external loading. Conclusion: The halo vest seems to be the first choice for conservative treatment of unstable injuries of the upper cervical spine, although pin track problems, accurate fitting of the vest, and a lack of patient compliance lead to clinical failures.
AB - Background: Although cervical orthoses are frequently used in prehospital stabilization and in the definitive treatment for lesions of the cervical spine, there is little information about the control of extension-flexion, lateral bending, and rotation given to individual segments by different designs. Methods: In an experimental in vitro study with four fresh frozen cadavers, the halo vest was compared with the soft collar, prefabricated Minerva brace, and Miami J collar. The controlling effects for the segments C1-2 and C2-3 were tested for all four devices in the intact and the unstable spine with an Anderson type II fracture of the odontoid. Results: All four orthoses reduced the range of motion at both C1-2 and C2-3 of the intact spine significantly, although none of the three semirigid devices provided a halo-like immobilization in the intact spine. The osteotomy of the odontoid increased the range of motion in the segment C1-2. The soft collar did not give any clinically relevant stability to the unstable spine. Miami J and Minerva brace provided a similar moderate control in the sagittal plane but a much better control of "torque" in the upper cervical spine. The halo vest did not allow any measurable motion in any plane with our experimental external loading. Conclusion: The halo vest seems to be the first choice for conservative treatment of unstable injuries of the upper cervical spine, although pin track problems, accurate fitting of the vest, and a lack of patient compliance lead to clinical failures.
KW - Biomechanics
KW - Cervical spine
KW - Odontoid fracture
KW - Orthosis
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U2 - 10.1097/00005373-200105000-00012
DO - 10.1097/00005373-200105000-00012
M3 - Article
C2 - 11371840
AN - SCOPUS:0034989113
VL - 50
SP - 848
EP - 854
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -