PO-08 · Spinal Orthoses

Spinal Orthoses. Part of the Prosthetics & Orthotics series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: It restricts extension about 70%. Side bending restriction is about 66% and rotation restriction is about 74%. ... they are stopped with roughly 30% of their normal arc remaining. — Correct: The 66% figure is the percentage of lateral bending the collar permits, not the percentage it restricts. The reference table reports mean percent of normal motion, so the Philadelphia collar restricts lateral bending by roughly 34%, and rotation by roughly 56%. The inference drawn from it in this passage, that the wearer is left about 30% of the arc in every plane, does not hold for lateral bending. (2) In the audio: Yeah, side bending and rotation both land around 66%. — Correct: For the SOMI the lateral bending figure is again motion permitted: the restriction is roughly 34%. The rotation figure of 66% is already a restriction figure and is correct. (3) In the audio: Side bending is actually the Minerva's weak plane, sitting at about 51% restriction. — Correct: The Minerva has no weak plane. The circumferential forehead band controls every cervical plane, and the reference's own table puts the Minerva lowest of all non-halo devices in the lateral bending column, which makes lateral bending one of its strengths. Its limitations are bulk, discomfort and cost. (4) In the audio: located posterior and slightly above the ears, — Correct: The posterior halo pins are placed posterolateral and just below the widest part of the skull. Below the equator is what stops the ring migrating upward; at or above ear level the pin sits at or above the greatest skull diameter and the ring can ride up. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/PO-08.