A cervical collar or a neck brace is an orthopedic brace that is used to support the cervical spine and the head. This is used to protect the neck after an injury to prevent further injury and for therapeutic purposes to relieve pain. It helps in realignment of the cervical vertebrae to prevent further injury. There are many types of cervical collars in the market for different indications. Cervical collars are also used to immobilize and relieve pain of strain and sprain injury to the neck part. These types will be discussed in detail but before anything else, it is paramount to know the importance of the cervical spine and its function to know the importance of using a neck brace for support. Cervical collars are also used to protect the neck during transport and from moving a patient suffering neck injury from one bed to another.
Importance of Cervical Spine
Common cervical spine injuries are due to falls, heavy weight bearing and motor vehicle accidents. In emergency scenarios, whenever a paramedic suspects for a head or neck injury, they should automatically immobilize the area suspected by splinting the spine using a board and they usually utilize a cervical collar to support the neck until a diagnostic exam such as a cervical X-ray is done to rule out cervical spine injury. The cervical spine needs support after an injury because it could lead to paralysis or even death. Injury to the level of C1, C2 and C3 levels of the cervical spine may require the patient to be hooked to a mechanical ventilator because it typically affects the function of breathing and diaphragm. The patient will have difficulty of breathing and will have low oxygen saturation levels in the arterial blood gas results. This is the most critical levels of the cervical spine and needs immediate treatment. Injury to the level of C4 leads to the loss of function of the biceps and shoulders. Injury to the level of C5 leads to loss of arm function up to the wrists and hands. Injury to the level of C6 leads to limited wrist control and hand functions. Injury to the last cervical level or level C7 of the spine leads to loss of dexterity of hands and fingers but allows for limited use of arms.
Cervical Collar Types
There are several types of collars according to the comfort and indications. They come from different sizes to cater different ages and come with a soft or hard material. Most common types have been named after the company manufacturing it.
Soft collar or standard cervical collar is made from foam covered with stockinet and has a Velcro strap for support. It is used for minimal cervical spine injury. It is designed for minimal head and neck control. It is cheaper and can be washable. It is comfortable to wear and has a cushion-effect.
Philadelphia collar is a two-piece collar. One part is for the back part of the neck while the other is for the front part and has a Velcro on left and right sides for easier removal and attachment. The total cervical arch support helps in maintaining cervical alignment. It is specially contoured for excellent stabilization and comfort. It is has a chin rest to make it comfortable for the wearer and to provide more immobilization. It is made from a stiffer material and has a hole in the middle for tracheostomy purposes. This is usually utilized if there is a great risk for respiratory function loss. If not used for tracheostomy purposes, the hole provides good ventilation for patient’s comfort and helps in reducing heat and moisture build up.
Miami-J collar is very much similar to a Philadelphia collar but can have a thoracic extension brace to protect also the thoracic spine, allowing more protection to the spine. It also has a front and back parts, also having a hole for tracheostomy purposes. This is an innovation to the Philadelphia collar and sizing and fitting has been more varied to provide more comfort to the patient. Material has protective paddings on the inner surface to prevent formation of decubitus ulcers from prolonged wearing.
Thomas-Type collar’s material is made from vinyl plastic and has several small holes to provide ventilation. This type of brace is similar to the soft collar but provides a more rigid support because of its material. It comes with foam padding on the upper and lower edges to prevent pressure sores. A chin support can be attached upon fabrication to provide more comfort.
Aspen collar is similar to both Miami-J and Philadelphia types but the padding material used in the inner surface is a lot breathable than the other types. It also comes with a hole for tracheostomy purposes.