A neck brace, also known as a cervical collar is used to provide stability and support to the cervical spine. They are used to immobilize areas of neck and support your cervical region when there is a condition that needs to be treated. Neck braces offer a non-invasive and safe option to manage or prevent neck pain, treat spinal deformities, muscle weakness, and provide support during the healing process. The common conditions that may require cervical neck collars are extreme sports activities, traumatic neck or head injuries, recovery stage after surgery, therapeutic stage after whiplash injuries, cervical radiculopathy and neck pain.
There are different types of neck braces available in the medical market. They offer varying levels of support and immobilization. Depending upon your requirements, your surgeon will determine the type of brace.
For patients who require a minimal amount of support for neck and head, soft neck collars are the best choice. They keep the neck and head stable and still to prevent injury. They do not completely immobilize the neck, but they restrict neck and head motion. They provide muscular support during movement. They are used after using the hard cervical collars for a certain period of time for the major healing. So basically, soft ones are used as a transition to wearing no collar.
They are comfortable and allow necessary motion required for daily activities. They are mainly used to fix minor cervical issues and after whiplash injury. They are usually helpful for minor neck injuries, and are typically used for few hours a day.
Design – Soft neck collars are made of dense polyurethane foam with a moisture-wicking outer cover. They are cut to mould around the patient’s neck and jaw. This flexible brace is wrapped around the neck with the help of a velcro closure. It can be washed completely, and comes with skin respiration that prevents the risk of itching and irritation of skin.
Indications – The indications for soft neck collars include:
Minor cervical issues
Degenerative disc disease
Hard or rigid neck collar
Made from molded plastic, rigid neck braces provide good support and help in recovering from various kinds of neck pain. It limits the forward and backward movements of neck. They are usually recommended after you have used the halo titanium ring. Rigid neck collar is mainly prescribed to those who have undergone surgery or after severe head or neck injury.
Design– Rigid neck collars come in a variety of sizes to fit the patient’s neck appropriately. The outer layer comprises of a hard thermoplastic support, while the inner layer is made of soft padding. It is important to wear your hard neck collar correctly. It is important that the collar is fitted tight enough to give sufficient support to your neck.
Indications: Some of the conditions for which rigid neck collars can be used are –
Acute neck pain
Acute neck injury
Degenerative neck disease
Philadelphia neck collars
Philadelphia is a stiff foam collar that has a front and back piece, which are attached on the sides with Velcro. The upper part of this collar supports the lower jaw, while the extension part covers the upper thoracic spine. It is usually used round the clock and should stay on until your doctor tells you remove it. Philadelphia neck collar is mainly used for conditions in which greater restrictions on motion are required. This includes upper spine fractures, cervical fusion surgery, or a cervical strain.
Design – It has a two-piece design, where the front and the back piece are held together by Velcro straps. It is a lightweight, two-piece polyethylene foam material with tough plastic supports at front and rear. While wearing, you need to ensure that the collar is placed in center and the Velcro straps are firmly applied. It offers rigid stabilization with comfort.
Indications – The main indications for Philadelphia neck collars include:
Cervical fusion surgery
Significant strain on neck ligaments
Neck fractures causing instability of cervical spine
Miami J Cervical collar
Often known as the advanced form of Philadelphia collar, Miami J is designed for providing extra comfort for the patients with neck injury. The sizing and fitting of Miami J collar is variable to provide the best comfort to the patient. It comes with an additional thoracic extension brace that provides support and protection to the thoracic spine.
Design – The design of Miami is similar to that of Philadelphia neck collar except the addition of a thoracic extension brace. It comprises of front and back parts that are connected with Velcro straps. The inner side of the braces is covered with protective padding that provides comfort and prevents skin irritation and itching.
SOMI or Sterno-occipital mandibular immobilization device is a type of rigid neck brace that holds your neck in a straight line with the spine. Basically, it is used to align the cervical region of the neck with the spine to fix the damage done to the neck. It offers a rigid support and prevents a person’s head from moving. Immobilization helps the faster healing of the damaged structures in the neck. While using SOMI neck brace, the patient is not allowed to twist or bend his neck.
Design – SOMI neck collar consists of several parts that provide support to sternum, jaw and neck. It has a chest plate or sterno at its front, which is connected to the bars going over the shoulder. The chest piece connects to the occipital piece that supports the back of your head. Your lower jaw rests on the chin piece that is connected by straps to a headpiece that is worn across the head. Although complicated to wear as compared to other types of braces, SOMI braces provide excellent support for an injured neck.
Indications – SOMI neck braces are mainly used after cervical spinal surgery or severe neck injury in which head and neck movements could be detrimental. By supporting multiple areas at various levels, they provide excellent support and faster recovery. The drawback of SOMI is that it controls extension less effectively as compared to other braces. Their main indications include:
Atlantoaxial instability caused by rheumatoid arthritis
Neural arch fractures of C2, because flexion causes instability
Aspen cervical collar
Aspen neck brace is similar to Philadelphia and Miami-J collar types in most of its design and use. The only difference is in the type of material used for padding. Aspen cervical braces use much more breathable padding material as compared to other two types of cervical collars. It has a hole in the center for the purpose of tracheostomy.
Thomas type neck collar
This is a less commonly used type of neck braces. It is made from vinyl plastic and has small holes for ventilation. It’s design is similar to that of soft collar. The only differentiating point is the use of tough material. This provides more rigid support to the neck. It comes with a foam padding on both upper and lower sides of the braces. This helps in preventing pressure sores.
Halo Device or Halo neck collar
Halo neck support, also known as Halo bracing is the most rigid of all the types of braces. It is mainly prescribed to eliminate or restrict movements in the slanting and coronal levels of the cervical spine. It keeps the neck and head in a correct position so as to allow faster healing of the injured spinal column and ligaments. It usually takes twelve weeks to heal the injured or affected areas in the neck.
Design – It features a metal ring secured to the head of patient by using metal pins. These four metal pins secure the halo or titanium ring around your head. The ring is then connected to a vest by four bars. This heavy vest is worn on your chest. The goal of vest is to hold the halo and your head steadily in place. It works by exerting a form of spinal traction, where the traction pulls your spinal column in 2 different directions. This in turn creates the tension that reduces the abnormal curvature found in spinal conditions such as Scoliosis. While wearing Halo brace, bending and twisting your body is completely restricted. It is a complex type of brace that is worn and removed only with the help of physician. You can not remove it by your own.
Indications – Halo neck collar is mainly indicated after a complex cervical surgery or unstable cervical fracture. The indications for Halo neck brace include:
Cervical Spine Trauma
Severe Instability of the Cervical Spine
Post Operative Stabilization
Cervical Thoracic Orthosis neck support (CTO)
CTO or Cervical Thoracic Orthosis neck support is used to treat fractures in the cervical spine and the upper back. They provide more support and stability as compared to rigid neck collars. They are designed to provide support and control on different planes, such as rotational, anterior and posterior, and medial and lateral. It not just immobilizes your head, bt also restricts flexion and extension. The aim of CTO neck brace is to keep your neck and head in a neutral position, which in turn promotes healing and prevents further injury. CTO are further available in different styles that serve different purposes. You need to consult your physician to find the right one that meets your needs.
Design – Cervical Thoracic Orthosis comprises of a front piece and a back piece- both of which are connected with straps. The lower rib cage and the back headpiece are connected to the front chin rest with the help of straps. Your doctor will help you wear this neck brace. You will be able to carry out several normal activities by yourself or with little help.
Indications – CTO is indicated in:
Cervical and Upper Thoracic Spine Trauma
Degenerative Disc Disease
Cervical and Upper Thoracic Spine Instability
Neck braces or neck collars are meant to provide support and stability to the neck, head and back region. It is important to choose the best one for you to avail the maximum benefit of neck collar. Neck collar can be associated with some common problems such as skin irritation and itching, skin sores, problem in swallowing and eating, weakness in neck muscles and troubles with balance. Consult your physician if you experience any of these effects.