Using Your CTO at Home
Purpose of the CTO
Your CTO (Cervical-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.
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. You cannot drive in a
CTO brace and you may not remove the
brace to drive.
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 (which 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. While on your
side, have someone clean and dry your back
and also replace the dirty pads if needed. Do
not bend or twist at all when your brace is
off or loose! Have someone place the back
portion of the brace against your head and
back and 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
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 could also help hold your head still
while you shave lying down.
ξ 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.
ξ Shirts that button are easier to get on
and off than t-shirts.
ξ 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
ξ 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.
ξ 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.
How long do I need to wear the CTO?
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
What should I do if I need adjustments to
or concerns about my CTO brace?
Patients should call the Orthotics Clinic at
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
Patients of the Neurosurgery Clinic please
call (608) 263-1410
Patients of the Orthopedic Rehabilitation
Spine Clinic call (608) 265-3207
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.
Your health care team may have given you
this information as part of your care. If so,
please use it and call if you have any
questions. If this information was not given
to you as part of your care, please check
with your doctor. This is not medical advice.
This is not to be used for diagnosis or
treatment of any medical condition. Because
each person’s health needs are different, you
should talk with your doctor or others on
your health care team when using this
information. If you have an emergency,
please call 911.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 2/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#6831.