Cervical Thoracic Orthosis (CTO): How to Care for Your Child

Your child is wearing a cervical thoracic orthosis (CTO) to keep the neck and upper back stable so they can heal safely. CTOs usually are worn for a short period of time. Kids get used to wearing them.

A CTO holds a child's head and neck in place so that spinal bones, or vertebrae, can heal from an injury, surgery, or spinal problem. ("Cervical" refers to the neck; "thoracic" refers to the upper back; "orthosis" is another word for "brace.")

A CTO is made of hard plastic and has foam padding for comfort. Some CTOs have clips, metal bars, or fabric straps. These help to keep the brace in place and the neck from moving.

• Check the area around the CTO each day for signs of skin irritation (redness, sores, or scratches).

• The health care provider will tell you whether it's OK to remove the CTO for bathing or at other times.

• If it's not OK to remove the CTO, your child can take sponge baths.

• If your health care provider says it's OK to wash the CTO, use soap and water and allow it to air dry. Do not use heat. Your child should wear a second CTO while you clean and dry the first one.

• Clear the floors at home of tripping hazards. Your child will not be able to look to the side, up, or down normally while wearing the brace.

• Schedule any follow-up appointments as directed.

• Follow the health care provider's instructions about when your child can return to school, childcare, and other activities.

• Tell teachers, childcare providers, and other adults who care for your child about what activities are allowed and whether it's OK to remove the brace.

• If your teen is a licensed driver, he or she should not drive while wearing the CTO.

• Your child has redness, irritation, a rash, or a skin sore near the CTO.

• The CTO doesn't fit properly.

• The CTO cracks or breaks.

• Your child has a headache or back pain.

• Your child starts vomiting.

• Your child has trouble breathing or swallowing.

Your child:

• Falls or is in an accident while wearing the CTO.

• Develops a severe headache.

• Develops numbness or tingling in the arms or legs.