Document Type : Original Articles

Authors

1 Department of Orthotics and Prosthetics ,School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Department of Rehabilitation Sciences Research Center, Shiraz University Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.

10.30476/jrsr.2024.101296.1460

Abstract

Background: To facilitate the fusion of the injury site for non-operative treatment or postoperative care, various braces are available to immobilize an unstable cervical spine. Among these, Minerva and Halo braces are the most effective and widely used for immobilizing unstable cervical spine injuries. The performance of cervical braces is commonly evaluated by the degree of motion restriction they provide. This study aimed to compare the function of modified Iranian and rigid Minerva braces using three-dimensional motion analysis as the standard assessment method.
Methods: Twenty-nine healthy male subjects without any history of spinal pain, malformation, or surgery were recruited for this cross-sectional study. A 3D motion capture system was used to record cervical and thoracic spine flexion, extension, lateral bending, and rotation. Range of motion (ROM) was assessed under three conditions: without a brace, with the modified Iranian Minerva brace, and with the rigid Minerva brace.
Results: At the cervical region, immobilization in flexion (89.03% > 87.8%) and rotation (84.85% > 83.19%) was greater with the modified Iranian Minerva, whereas extension (89.37% > 85.95%) and lateral bending (81.26% > 71.71%) were more restricted by the rigid Minerva (p > 0.05). At the thoracic region, immobilization in flexion (76.35% < 75.96%), lateral bending (46.92% > 44.5%), and extension (79.44% > 62.58%) were higher with the rigid Minerva, while rotation (53.04% > 41.21%) was more limited by the modified Iranian Minerva (p > 0.05).
Conclusion: Both Minerva braces significantly reduced cervical range of motion (p < 0.05). The rigid Minerva was more effective in controlling extension and lateral bending, while the modified Iranian Minerva provided greater restriction in flexion and rotation (p < 0.05).

Highlights

Hossein Asiyaeimehr

Keywords

  1. Johnson RM, Owen JR, Hart DL, Callahan RA. Cervical orthoses: a guide to their selection and use. Clin Orthop Relat Res. 1981(154):34-45.
  2. Hart DL, Johnson RM, Simmons EF, Owen J. Review of cervical orthoses. Phys Ther. 1978;58(7):857-60.
  3. Karimi MT, Kamali M, Fatoye F. Evaluation of the efficiency of cervical orthoses on cervical fracture: A review of literature. J Craniovertebr Junction Spine. 2016;7(1):13-9.
  4. Askins V, Eismont FJ. Efficacy of five cervical orthoses in restricting cervical motion. A comparison study. Spine (Phila Pa 1976). 1997;22(11):1193-8.
  5. Richter D, Latta LL, Milne EL, Varkarakis GM, Biedermann L, Ekkernkamp A, Ostermann PA. The stabilizing effects of different orthoses in the intact and unstable upper cervical spine: a cadaver study. J Trauma. 2001;50(5):848-54.
  6. Schneider AM, Hipp JA, Nguyen L, Reitman CA. Reduction in head and intervertebral motion provided by 7 contemporary cervical orthoses in 45 individuals. Spine (Phila Pa 1976). 2007;32(1):E1-6.
  7. Michael J. Vives M PKY, MD, Steven R. Garfin, MD. Spinal Orthoses for Traumatic and Degenerative Disease 2016 [
  8. Benzel EC, Hadden TA, Saulsbery CM. A comparison of the Minerva and halo jackets for stabilization of the cervical spine. J Neurosurg. 1989;70(3):411-4.
  9. Tomaszewski R, Sesia SB, Studer D, Rutz E, Mayr JM. Conservative treatment and outcome of upper cervical spine fractures in young children: A STROBE-compliant case series. Medicine (Baltimore). 2021;100(13):e25334.
  10. Tomaszewski R, Koszutski T. Treatment of the dens fractures in children. Neurol Neurochir Pol. 2018;52(5):618-22.
  11. Glaser JA, Whitehill R, Stamp WG, Jane JA. Complications associated with the halo-vest. A review of 245 cases. J Neurosurg. 1986;65(6):762-9.
  12. Baerg TN, Ha JF, Christ M, Green GE. Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection. Ear Nose Throat J. 2021;100(2):Np105-np8.
  13. Johnson RM, Hart DL, Owen JR, Lerner E, Chapin W, Zeleznik R. The yale cervical orthosis: an evaluation of its effectiveness in restricting cervical motion in normal subjects and a comparison with other cervical orthoses. Phys Ther. 1978;58(7):865-71.
  14. Holla M, Huisman JM, Verdonschot N, Goosen J, Hosman AJ, Hannink G. The ability of external immobilizers to restrict movement of the cervical spine: a systematic review. Eur Spine J. 2016;25(7):2023-36.
  15. Vives MJ. 2018 [Available from: https://musculoskeletalkey.com/bracing-and-orthoses-2/.
  16. Ceseracciu E, Sawacha Z, Cobelli C. Comparison of markerless and marker-based motion capture technologies through simultaneous data collection during gait: proof of concept. PLoS One. 2014;9(3):e87640.
  17. Poitras I, Dupuis F, Bielmann M, Campeau-Lecours A, Mercier C, Bouyer LJ, Roy JS. Validity and Reliability of Wearable Sensors for Joint Angle Estimation: A Systematic Review. Sensors (Basel). 2019;19(7).
  18. Evans NR, Hooper G, Edwards R, Whatling G, Sparkes V, Holt C, Ahuja S. A 3D motion analysis study comparing the effectiveness of cervical spine orthoses at restricting spinal motion through physiological ranges. Eur Spine J. 2013;22 Suppl 1(Suppl 1):S10-5.
  19. Hosseini PS, Karimi MT, Abnavi F, Golabbakhsh M. Evaluation of the efficiency of Minerva collar on cervical spine motions. Journal of Rehabilitation Sciences & Research. 2017;4(2):47-52.
  20. Inokuchi H, Tojima M, Mano H, Ishikawa Y, Ogata N, Haga N. Neck range of motion measurements using a new three-dimensional motion analysis system: validity and repeatability. Eur Spine J. 2015;24(12):2807-15.
  21. Walters BC, Hadley MN, Hurlbert RJ, Aarabi B, Dhall SS, Gelb DE, et al. Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 2013;60(CN_suppl_1):82-91.
  22. Chan RC, Schweigel JF, Thompson GB. Halo-thoracic brace immobilization in 188 patients with acute cervical spine injuries. J Neurosurg. 1983;58(4):508-15.
  23. Sawers A, DiPaola CP, Rechtine GR, 2nd. Suitability of the noninvasive halo for cervical spine injuries: a retrospective analysis of outcomes. Spine J. 2009;9(3):216-20.
  24. Lee D, Adeoye AL, Dahdaleh NS. Indications and complications of crown halo vest placement: A review. J Clin Neurosci. 2017;40:27-33.
  25. Hashimoto Y, Doita M, Hasuda K, Korosue K. Intracerebral pneumocephalus and hemiparesis as a complication of a halo vest in a patient with multiple myeloma. Case report. J Neurosurg. 2004;100(4 Suppl Spine):367-71.
  26. Park P, Lodhia KR, Eden SV, Lewandrowski KU, McGillicuddy JE. Pin-site myiasis: a rare complication of halo orthosis. Spinal Cord. 2005;43(11):684-6.
  27. Odderson IR, Lietzow D. Dysphagia complications of the Minerva brace. Arch Phys Med Rehabil. 1997;78(12):1386-8.
  28. Johnson RM, Hart DL, Simmons EF, Ramsby GR, Southwick WO. Cervical orthoses. A study comparing their effectiveness in restricting cervical motion in normal subjects. J Bone Joint Surg Am. 1977;59(3):332-9.
  29. Hughes S. Efficacy of five cervical orthoses in restricting cervical motion: a comparison study. Spine (Phila Pa 1976). 1998;23(6):744.
  30. Hughes SJ. How effective is the Newport/Aspen collar? A prospective radiographic evaluation in healthy adult volunteers. J Trauma. 1998;45(2):374-8.
  31. Maiman D, Millington P, Novak S, Kerk J, Ellingsen J, Wenninger W. The effect of the thermoplastic Minerva body jacket on cervical spine motion. Neurosurgery. 1989;25(3):363-7; discussion 7-8.
  32. Qu N, Graven-Nielsen T, Lindstrøm R, Blogg Andersen Dc V, Hirata RP. Recurrent neck pain patients exhibit altered joint motion pattern during cervical flexion and extension movements. Clin Biomech (Bristol, Avon). 2020;71:125-32.
  33. Taqi AH, Faraj KA, Zaynal SA. The Effect of Long-Term X-Ray Exposure on Human Lymphocyte. J Biomed Phys Eng. 2019;9(1):127-32.
  34. Zhang S, Wortley M, Clowers K, Krusenklaus JH. Evaluation of efficacy and 3D kinematic characteristics of cervical orthoses. Clinical biomechanics. 2005;20(3):264-9.
  35. Lind B, Sihlbom H, Nordwall A. Halo-vest treatment of unstable traumatic cervical spine injuries. Spine (Phila Pa 1976). 1988;13(4):425-32.
  36. Morishima N, Ohota K, Miura Y. The influences of Halo-vest fixation and cervical hyperextension on swallowing in healthy volunteers. Spine (Phila Pa 1976). 2005;30(7):E179-82.