A cervical thoracic orthosis (CTO) is a type of brace that supports the neck and upper back, relieves pain, and prevents movement that could cause harm. It's made of hard plastic, has foam padding for comfort, and is usually held in place by straps.

Your child is wearing a cervical thoracic orthosis to keep their neck and upper back still so they can heal safely. Here's how to care for your child and the cervical thoracic orthosis.

Follow your health care provider's instructions for:

• When and how long your child needs to wear the cervical thoracic orthosis.
• Whether it's OK to take the cervical thoracic orthosis off during bathing. If your child needs to bathe with the cervical thoracic orthosis on, your child can take sponge baths.
• To take a sponge bath:
  • Wet a sponge or washcloth with warm water and a little fragrance-free, gentle soap and wring until just damp.
  • Starting with the face (avoid the eyes) and working down to the feet, wipe the skin with the sponge or washcloth. Take special care to avoid the cervical thoracic orthosis.
  • Rinse the sponge or washcloth with plain, warm water and wring until just damp. Wipe the skin again to remove any soap.
  • Dry the skin with a clean towel.
• What to wear under the cervical thoracic orthosis to protect the skin. Usually a thin T-shirt is best.
• Any activities to avoid.
• When your child can return to school, sports, and other activities.
• Cleaning the cervical thoracic orthosis.
• Making appointments with a physical therapist.
• Scheduling follow-up appointments.

Important reminders:

• Check the area around the cervical thoracic orthosis each day for signs of skin irritation (redness, sores, or scratches).
• 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.
• 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 cervical thoracic orthosis.
• Your teen will not be able to drive while wearing the cervical thoracic orthosis. Make plans to drive them or get them rides to school and other activities.

• Your child has redness, irritation, a rash, or a skin sore near the cervical thoracic orthosis.
• Your child has any new or worsening symptoms, such as a headache or neck or back pain.
• Your child's arm is pale, swollen, or weak, or it feels numb or tingly.
• The cervical thoracic orthosis is too loose or too tight.
• The cervical thoracic orthosis cracks or breaks.

Your child falls or is in an accident while wearing the cervical thoracic orthosis.

Who needs to wear a cervical thoracic orthosis? Health care providers use a cervical thoracic orthosis to treat people with cervical thoracic outlet syndrome, people with injuries of the neck or spine, and people who had surgery on the neck or spine.

What is cervical thoracic outlet syndrome? It is a condition where the nerves or blood vessels in the neck and upper chest get squeezed or compressed. This can cause pain, numbness, tingling, and weakness in the shoulder, arm, and hand. In kids and teens, it is usually caused by injuries (such as a fall or a car crash) or by doing the same motion over and over again (for example, in sports or playing an instrument).

How long will my child need to wear the cervical thoracic orthosis? It depends on your child's condition. Most of the time, kids need to wear a cervical thoracic orthosis for a few weeks or months. But some kids need to wear it longer.