COF Spinal Orthotic Devices 2 — Questions and Answers
Question 1: A TLSO is primarily indicated for which of the following conditions?
- Cervical radiculopathy
- Thoracolumbar burst fractures (Correct answer)
- Plantar fasciitis
- Carpal tunnel syndrome
Correct answer: Thoracolumbar burst fractures
A thoracolumbar sacral orthosis (TLSO) stabilizes the thoracolumbar region and is a primary non-surgical treatment for burst fractures at that junction.
Question 2: Which spinal orthosis is most appropriate for managing adolescent idiopathic scoliosis with a Cobb angle between 25° and 40°?
- Milwaukee brace
- Boston brace (Correct answer)
- Philadelphia collar
- Jewett hyperextension orthosis
Correct answer: Boston brace
The Boston brace (TLSO) is the most widely prescribed orthosis for adolescent idiopathic scoliosis in the thoracolumbar and lumbar regions within that Cobb angle range.
Question 3: The three-point pressure principle used in spinal orthotics involves applying corrective forces in how many directions?
- Two opposing directions
- Three directions, with two forces on one side and one counterforce on the other (Correct answer)
- Four equal and opposite directions
- One primary direction with no counterforce
Correct answer: Three directions, with two forces on one side and one counterforce on the other
The three-point pressure system applies two forces on one side of the deformity and a single counterforce between them on the opposite side to achieve correction.
Question 4: A patient with an L4-L5 disc herniation and mild instability would most likely be fitted with which orthosis?
- Cervical collar
- Lumbar corset with stays (Correct answer)
- Chairback TLSO
- Halo vest
Correct answer: Lumbar corset with stays
A lumbar corset with rigid stays provides mild support and proprioceptive feedback for lumbar disc pathology without full rigid immobilization.
Question 5: Which of the following is a rigid lumbar orthosis that limits flexion, extension, and lateral bending but allows some rotation?
- Soft lumbar corset
- Chair-back LSO (Correct answer)
- Jewett orthosis
- Williams flexion orthosis
Correct answer: Chair-back LSO
The chair-back LSO uses rigid posterior uprights and abdominal apron to limit lumbar motion in three planes while permitting some axial rotation.
Question 6: The Jewett hyperextension orthosis works by applying a three-point system to prevent which motion?
- Extension
- Flexion (Correct answer)
- Lateral bending
- Axial rotation
Correct answer: Flexion
The Jewett orthosis uses sternal, pubic, and thoracolumbar pads to block forward flexion, making it ideal for stable compression fractures.
Question 7: When fitting a Boston brace for scoliosis, the orthotist positions the lateral thoracic pad directly over which anatomical landmark?
- The apex of the curve (Correct answer)
- The neutral vertebra
- The iliac crest
- The spinous process of T12
Correct answer: The apex of the curve
The lateral thoracic pad is placed at the apex of the primary curve to apply the corrective three-point force directly where curvature is greatest.
COF Spinal Orthotic Devices 2
A TLSO is primarily indicated for which of the following conditions?