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CTO Brace

What a CTO brace and why do I need it?

  • CTO stands for cervical thoracic orthosis.

  • A CTO is designed to limit the movement of your neck and upper back. It is most commonly used to manage spinal fractures but can also be used for other reasons such as supporting your spine after surgery.

  • Your doctor will tell you when to wear your brace during the day and for how long to wear it.

  • Always wear a snug T-shirt under the brace or thin layer of clothing to create a barrier between your skin and the brace to prevent rubbing or sores. 

How do I put on my brace?

Do not attempt to put the brace on by yourself. It is best to have 3 caregivers to help you put the CTO, on but you will need at least 2 caregivers.

Put on your brace with three caregivers.

1. Have a caregiver remove your cervical collar while supporting your head and neck.

2. Have your caregivers move you to one side of the bed.

  • Your caregivers will move you to the side by pulling on the sheet. Keep your body completely straight with your hands crossed over your chest. 

CTO Brace

3. Have your caregivers “log roll” you to the other side of the bed so that the side of your stomach is on the bed.

  • Before turning on your side:

    If turning to your right, cross your left leg over your right leg.

    If turning to your left, cross your right leg over your left leg.

 

  •  If you are turning to your right, put your left leg over your right leg.  
    One caregiver should support your neck and head while turning.

  • Two caregivers should support your back and legs.  Do not twist your back! Keep your body in line and roll like a log keeping your shoulders, hips, and knees together.  .  

Keep your body in line and roll like a log.

4. A caregiver should place the back half of the CTO brace.

  • The back half of the brace should be secure against your head, neck, and upper back.

• The back half should be secure against your head, neck and upper back.  

5.  Hold the brace in place and log roll onto your back.

  • Make sure the back piece of the brace is centered on your body.

6.  Place the front of the brace on your neck and chest. 

  • Make sure the upper part of the front piece is under your chin.

  • Tuck the side flaps under the back part of the brace.

• Tuck the side flaps under the back part of the CTO.
7.  Tighten the straps around the sides of the neck brace..

  • Make sure the back half of the neck brace is over the front half of the neck brace on the sides, as shown in the picture below.

 Make sure the back half of the brace is over the front half of the brace on the sides.

  • Crisscross the neck straps. It does not matter which one is over which.

  Make sure you crisscross the neck straps.

  • Tighten the body straps in the lower part of your brace until it is snug.

  • Make sure the brace is lined up and snug before getting up.  Adjust the brace as needed.

  • Always wear the CTO as snug as you can to keep it from sliding up or down.

8.  Getting out of bed.

  • Log roll onto your side.

  • Drop your legs over the side of the bed and push yourself up so you are sitting on the edge of the bed.

Drop your legs over the side of the bed.

Push yourself up so you are sitting on the edge of the bed. 

9.  Getting into bed.

  • Sit on the side of the bed and lean down on your elbow and forearm.

  • Lift your legs up onto the bed while you lay on your side.

  • Log roll from your side onto your back.  

10. Check your brace again in the standing position.

  • Stand in front of a mirror to check it or have your caregiver check it for you.

  • Make sure the brace is centered on your body.

  • Make sure your face is straight forward.

  • Your head and neck should not be tilting forward or backward.

How do I take off my brace?

* Do not attempt to take the brace off by yourself. It is best to have 3 caregivers to help you take it off. You will need at least 2 caregivers.

  • Start by lying on your back with the brace on.

  • A caregiver should undo all the straps.

  • A caregiver should take off the front piece of the brace. You will need to keep your body straight.

  • Your caregivers should log roll you on to your side.

    • One caregiver holds your neck.

    • Two caregivers help roll your body.

  • Your caregivers should remove the back piece of the brace and put the back piece of your cervical collar back on.

  • Your caregivers should log roll you on to your back and put the front piece of your cervical collar back on and tighten the straps.

  • You should wear a cervical collar when you are in bed with the CTO off, unless your doctor tells you otherwise. The instructions for the cervical collar are in a separate handout.

Check your brace in the standing position.

Things to remember

  • The CTO should be tight but comfortable.

  •  Your chin should not sit inside or stick out over the collar, but flush with the collar edge.

  • If excessive sweating occurs, please remove the spinal brace and rest for short periods lying down – this is especially important if you have a wound from surgery.

  • Bathing and showering are not permitted unless you are given special instruction from your doctor.

 

Things to do:

  • Clean the brace with hot soapy water and a sponge. Towel or air dry.

  • Wear a snug T-shirt and pants with elastic waist under the brace.

  • Sit in a firm chair with armrests.

  • If you lose or gain weight your CTO will need to be adjusted.  To have your brace adjusted, call Bluegrass Bracing at 1-866-266-5500.

Things not to do:

  • Don’t use lotions or powders underneath your brace. They will bother your skin.

  • Don’t wear bras with underwires, sweaters, blue jeans or thick belts under your brace.  This will make your brace not fit properly.

  • Don’t put towels or washcloths under your brace as padding.  This will make your brace not fit properly.

  • Don’t sit in seat with soft cushions that you sink into. This will make the brace slide up.

  • Don’t try to adjust or modify the brace on your own.  Call Bluegrass Bracing at 1-866-266-5500 if your CTO needs adjustments.

 

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