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Cervical collar
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==Types== [[File:Cervical Collar Emergency.jpg|thumb|A neck collar being placed on a patient by emergency services.]] A soft collar is fairly flexible and is the least limiting but can carry a high risk of further breakage, especially in people with [[osteoporosis]]. They are usually made of felt. It can be used for minor injuries or after healing has allowed the neck to become more stable.{{cn|date=November 2023}} A range of manufactured rigid collars are also used, usually comprising (a) a firm plastic bi-valved shell secured with [[Velcro]] straps and (b) removable padded liners. The also contain a back pad, back panel, front pad, front panel, and chin pad. There are air holes throughout the device to provide ventilation to the area but also to allow access for a [[Tracheotomy|tracheostomy]] if needed. The rigidness is provided by plexiglass in some models. The most frequently prescribed are the Aspen, Malibu, Miami J, and Philadelphia collars. All these can be used with additional chest and head extension pieces to increase stability.{{cn|date=November 2023}} Cervical collars are incorporated into rigid braces that constrain the head and chest together.<ref>{{cite journal | url = http://emedicine.medscape.com/article/314921-overview | vauthors = Kulkarni SS, Meier III RH | date = 1 November 2018 | title = Spinal Orthotics | journal = Medscape }}</ref> Examples include the Sterno-Occipital Mandibular Immobilization Device (SOMI), Lerman Minerva and Yale types. Special cases, such as very young children or non-cooperative adults, are sometimes still immobilized in medical plaster of paris casts, such as the [[Orthopedic cast#Other casts|Minerva cast]]. Rigid collars are most restrictive when flexing the neck and least restrictive with lateral rotation when compared to soft collars.<ref>{{cite journal | vauthors = Barati K, Arazpour M, Vameghi R, Abdoli A, Farmani F | title = The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects | journal = Asian Spine Journal | volume = 11 | issue = 3 | pages = 390β395 | date = June 2017 | pmid = 28670406 | pmc = 5481593 | doi = 10.4184/asj.2017.11.3.390 }}</ref> Despite this, subjects have similar range of motion when asked to perform activities of daily living. It is thought that these collars provide a proprioceptive guide on how much to move one's neck and when patients are preoccupied with performing an activity they are able to move their neck more.<ref>{{cite journal | vauthors = Miller CP, Bible JE, Jegede KA, Whang PG, Grauer JN | title = Soft and rigid collars provide similar restriction in cervical range of motion during fifteen activities of daily living | journal = Spine | volume = 35 | issue = 13 | pages = 1271β1278 | date = June 2010 | pmid = 20512025 | doi = 10.1097/BRS.0b013e3181c0ddad | s2cid = 11231196 }}</ref> This is why in more minor injuries, cervical collars are still placed to remind patients of their injury so they can restrict any activities that may worsen their condition.
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