Using Your CTO at Home Trauma
Purpose of the CTO
Your CTO (Cervico-Thoracic Orthosis) is used to treat fractures in the cervical spine (neck) and the upper part of the thoracic spine (upper back). It maintains the head in a neutral position, reduces pain, prevents further injury and promotes healing. It will NOT totally immobilize your head. Mostly, it will block cervical flexion and extension (the ‘yes’ motion). It blocks cervical rotation (the ‘no’ motion) very little. You must try to restrict this motion on your own.
Wearing your CTO
Most often, the CTO consists of a front piece and back piece with shoulder straps, a strap around the lower rib cage and two straps that connect the back headpiece to the front chin rest. You should be able to do many normal activities by yourself or with a little help. Ask your doctor for detailed activity guidelines and restrictions. It is advised that you wear the CTO over a T-shirt for comfort and to protect your skin.
Preparing for Your Trip Home
You will need someone to drive you home. Your neck will not bend (flex) to get into a small car. Try to arrange a ride in a car with ample head room (large sedans, SUVs, Minivans, etc). It is also helpful if it has seats that recline.
Taking Off the CTO
You must wear your CTO as ordered by your doctor. If you are allowed to take it off for bathing, you MUST be lying down when you take it off. While lying flat, have someone loosen the straps over the shoulders and around the lower ribs. Hold the chin piece that should still be attached to the back head piece by straps at the jaw line, in place while you are log rolled onto your side. Loosen the chin straps and lift the back piece off. Do not bend or twist at all when your brace is off or loose! Have someone help you while you lay flat. Log roll back to a flat position and lift the chin piece off. Clean and dry the skin under the brace. Replace the lining pads with fresh ones. Hand wash and air dry the dirty pads.
Shaving
If you shave your face, it is best to have help to shave. It is a well-trained habit to move your head and neck while shaving. For years, you have tilted your head back to shave your neck. You must not do that now. Remove CTO as above and shave while lying flat. If someone else shaves you, you can focus on keeping your head still. Your helper can also help keep your head still.
Daily Activities
- Eating and drinking will be awkward at first, as you can't look down at your plate or tilt your head back to drink. Use a straw to drink, raise your table or use a low chair to get your plate as high as possible. Tuck a napkin or towel under your chin (between chin and pad and over chest piece) to catch spills.
- Shirts that button are easier to get on and off than t-shirts.
- Use caution when going down stairs, as you cannot easily look down. Stand at the top of the stairs, hold the handrail, and bend at the waist to look down the stairs to make sure your path is clear. You will be more top-heavy than usual, so be careful bending. Hold the handrail at all times, especially when going down.
- You also need to be careful when walking on uneven surfaces, or sidewalks that may have sudden changes due to roots raising some squares. Be very careful if it may be icy, since you may not be able to see a patch of ice.
- While you are here in the hospital and in bed, ask visitors to come up to the head of the bed to talk to you. Sometimes visitors don't realize that you can't turn your head to look at them or see them when they are at the foot of the bed.
Your doctor will decide this. You must follow your doctor’s advice even if you feel better and would like to stop wearing the CTO sooner. Your doctor will see you for follow-up care.
What should I do if my neurological symptoms get worse?
If you have more numbness, tingling, pain or are less able to move or do daily activities, call your clinic.
Call 911 if you experience sudden onset of weakness, or loss of bowel or bladder control.
Patients of the Neurosurgery Clinic please call (608) 263-1410
Patients of the Orthopedic Rehabilitation Spine Clinic call (608) 265-3507
After hours, nights, weekends, and holidays, call (608) 262-2122. This will give you the paging operator at the hospital. Ask for the resident on call for your clinic. Leave your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call 1-800-323-8942 and ask for your clinic.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 09/18/2012
Copyright © 09/18/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6831
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