BACK AND NECK BRACES

Doctors prescribe the sacroiliac belt Neck braces provide stability of the cervical spine after neck surgery, a trauma to the neck, or as an alternative to surgery.  You most commonly see people wearing these types of braces.  Doctors typically prescribe the following bracing:

Soft Collar

Typically used after a more rigid collar has been worn for major healing, this brace transitions to using no collar.

Philadelphia Collar

With a front and back piece that attaches with Velcro on the sides, this brace provides a more rigid/stiff collar.  Also, patients will wear this brace for 24 hours a day until their doctor instructs them to remove it.  In addition, this collar provides stability for a cervical (upper spine) fracture, cervical fusion surgery, or a cervical strain.

Sterno-Occipital Mandibular Immobilization Device (SOMI

A SOMI brace holds your neck in a straight line that matches up with your spine.  Furthermore, it offers rigid support to a damaged neck and prevents the head from moving around.  With this brace, you cannot bend or twist your neck.  To enable muscles and bones to heal from injury or surgery, this device restricts motion.

If you look at what the name means, you will better understand what a SOMI does: “sterno” means your upper and middle chest, “occipital” means the base of your skull, “mandibular” refers to your jaw and chin, and “immobilization” describes the support and movement restriction the brace offers.  First, the chin piece rests on the lower jaw.  Second, the chin piece connects by straps to a headband that goes across the forehead.  Third, the chin piece connects to a chest piece by a front metal extension.  Finally, the chest piece then rests on the upper and middle chest – sort of like a vest, which connects to the occipital piece that supports the base of the head. Note that This brace provides excellent support for an injured neck.

Halo

The Halo brace refers to the most rigid cervical brace that Immobilizes the head and neck.  For unstable cervical fractures or complex cervical spine surgery, doctors use this brace.  The halo device has a titanium ring (halo) that goes around your head, secured to the skull by four metal pins.  Then the ring attaches by four bars to a vest worn on the chest.  Meanwhile, a vest provides the stability to hold the ring and neck steadily in place.  In order for the spine to heal, patients will wear the Halo for 24 hours a day.

Trochanteric Belts

For sacroiliac joint pain or pelvic fractures, doctors prescribe the trochanteric belt.  To wear the belt, it fits around the pelvis, between the trochanter (a bony portion below the neck of your thigh bone) and the iliac (pelvis) ridges/crests.  Additionally, it measures about five to eight centimeters wide and it buckles in front, just like a regular belt.

Sacroiliac and Lumbosacral Belts

To stabilize the lower back, consists of heavy cotton and reinforced by lightweight stays.  Furthermore, the pressure can be adjusted through laces on the side or back of the belt.  Also, these belts range in widths between 10 to 15 centimeters, and 20 to 30 centimeters.  To prevent motion by putting pressure on the joints between the hipbone and sacrum (base of the spine), doctors prescribe the sacroiliac belt. 

Corsets

Corsets provide rigidity and support for the back and they can vary in length.  Depending upon the patient’s condition, doctors prescribe a shorter or longer corset .  Meanwhile, doctors prescribe the short corset for low back pain, while a longer one for problems in the mid to lower thoracic spine.  When people think of corsets, they usually conjure up images of women from earlier centuries who used them to make their waists look smaller.  Today, in the treatment of back problems, corsets refer to a type of back brace that extends over the buttocks and held up by shoulder straps.  

Rigid Braces

If patients require greater rigidity to support the spine because of low back pain and instability, doctors will prescribe stiff braces.  For instance, these braces usually consist of rear uprights that contour to the lumbar (lower) spine and pelvis, along with thoracic bands.  Additionally, there are also fabric straps on the braces that provide pressure in the front. The following identify Common types of rigid braces:

Williams Brace – This type of brace has no vertical uprights in the middle so that flexion/bending can occur.

Chair-back Brace – This type keeps the lumbar spine in a neutral position. The chair-back design prevents sideways and revolving movement of the lower spine.

Raney Flexion Jacket – This type prevents lumbar lordosis by holding the patient in a neutral tilt.

Hyperextension Braces

This brace prevents bending and often doctors prescribe this brace to treat frontal compression fractures that have occurred around the junction of the thoracic and lumbar spine.  Thus, this brace can also be used for post-surgery healing from a spinal fusion. Finally, these braces offer support that allows anterior (front) pressure unloading of the thoracic vertebrae by restricting flexion (bending) of the thoracic and lumbar spine.

To be more specific, hyperextension braces have a front rectangular metal frame that puts pressure over the upper sternum and the pubis/pubic bone.  Additionally, this encourages spinal extension and applies pressure over the T-10 level (the tenth vertebra in your thoracic spine).  The braces offer “three-point stabilization” to the spine through a front abdominal pad, a chest pad, and a rear pad at the level of the fracture.

By the brace applying pressure in three-points – sternal, pubis, and rear Lumbosacral – the spine becomes extended and stretched.   A narrow, flat bone in the front middle of the thorax refers to the sternum.  The thorax refers to the portion of the body between the base of the neck and the lower diaphragm.

The most common types of Hyperextension Braces are Knight Taylor and Jewett.

Molded Jackets

These jackets are designed to distribute pressure widely over a large area.  By immobilizing the patient from the neck to the hips, the pressure becomes evenly distributed evenly, taking excess pressure off overloaded or unstable areas. For example, these jackets were originally made of plaster of Paris, but now made out of molded plastic.

Lifting Belts

To prevent injury when lifting heavy objects, these belts reduce low back strain and muscle strains.  To use the belt, it circles around the waist, covering the lumbar region of the spine, and closes in front.  Also, these belts are usually made of cloth or canvas and some models have lordosis pads.

Clinical Uses of Back and Neck Braces

The braces/supports treat low back pain, trauma, infections, muscular weakness, neck conditions, and osteoporosis.  When a condition needs to be treated, braces, belts, and jackets help immobilize and support the spine.  Depending on the model used, they can put the spine in a neutral, upright, hyper-extended, flexed, or lateral-flexed position.

Goals of Spinal Bracing

For a variety of reasons such as to control pain; lessen the chance of further injury; allow healing to take place; compensate for muscle weakness, or prevent or correct a deformity, the use of Spinal bracing can greatly assist patients.  More specifically, lumbar corsets and braces compress the abdomen, which increases the intra-abdominal pressure.  This act allows pressure on the vertebral column to unload, providing some relief.

Possible Drawbacks of Back and Neck Braces

Although bracing primarily provides positive results, they can lead to a loss of muscle function, due to inactivity.  Bracing can sometimes lead to psychological addiction so that even when the patient is healed and ready to be taken off the back brace, he or she feels dependent upon it for physical support.