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 

Your CTO has a front and back piece with shoulder straps. There is 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 most things by yourself or with a little help. 


Talk with your doctor about your daily routine. It is advised that you wear the CTO over a T-shirt for comfort and to protect your skin. 

Heading 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 plenty of head room (large sedans, SUVs, vans, etc). It is 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 your doctor said you can take off for bathing, you must be lying down. 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) 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 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 dirty pads.

To learn how to put on and take off your brace, watch the CTO brace video or Minerva CTO brace video.


It is best to have help when you shave. It is a habit to move your head and neck while shaving. For years, you may 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, focus on keeping your head still. Your helper could also help hold your head still while you shave lying down. 

Daily Activities 

  • Eating and drinking will be awkward at first. You can't look down at your plate or tilt your head back to drink. To help, 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. 

  • Shirts that button are easier to get on and off. 

  • Use caution when going down stairs, you cannot easily look down. Stand at the top of the stairs, hold the handrail, and bend at the waist to look down to make sure your path is clear. You will be top-heavy, so be careful bending. Hold the handrail at all times when going down stairs. 

  • Be careful when walking on uneven or icy surfaces. Sidewalks may have sudden changes. 

  • Have visitors to come up to the head of the bed. People don't realize that you can't turn your head to look at them and you can’t see them at the foot of the bed. 

How long do I need to wear the CTO? 

Follow your doctor’s advice even if you feel better. Your doctor will see you for follow-up care and decide this. Call if your CTO needs to be adjusted.

If the CTO needs adjustments call:

UW Health Orthotics Clinic 

(608) 263-0583 

When to Call

If you have more numbness, tingling, pain, less able to move or do daily activities, call your clinic. Call 911 if you experience sudden onset of weakness, loss of bowel or bladder control. 

Who to Call

Neurosurgery Clinic 

(608) 263-1410 

Orthopedic Rehabilitation Spine Clinic (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.