Head Piece with Cervical Attachment for Infantile Spinal Muscular Atrophy


A girl with infantile spinal muscular atrophy and associated scoliosis and cardiac and pulmonary involvement was presented for orthotic evaluation. She exhibited complete absence of trunk and cervical support and lowerlimb weakness. She was able, however, to support her body, ambulate when her torso was stabilized, and she could rotate her head from left to right.

The initial request was for a canvas body jacket with attached head piece. The head piece was intended to support the head in the frontal and sagittal planes while allowing rotation, and the body jacket was designed to support the trunk and control the scoliosis. It was eventually agreed that a plastic lowprofile body jacket would be preferable. Initial attempts to fabricate a head piece to fit onto the plastic jacket were unsuccessful because of breakage or lack of precise alignment. The head-cervical piece now in use incorporates an adjustable locking ball and socket arrangement for precise alignment and head positioning while controlling anteroposterior and mediolateral motion, and allows rotation by virtue of its attachment to the body jacket. In combination with a frame-design plastic head piece, it provides stability and adjustment where needed, free rotation, alignment capability, simplicity of design, and is durable.

Kessler Institute for Rehabilitation, Inc., 240 Central Avenue, East Orange, NJ 07018