DeRoyal CTO Cervical Thoracic Orthosis Neck Brace — 3-in-1 Modular Extension System
The DeRoyal CTO Cervical Thoracic Orthosis provides superior immobilization of the cervical and upper thoracic spine with comprehensive support in all directions. This innovative 3-in-1 modular system allows for gradual relaxation of immobilization during patient recovery — one brace adapts throughout the entire rehabilitation process. Available in Adult (Short, Regular, Tall, X-Tall) and Pediatric sizes.
What Is a CTO and How Is It Different from a Standard Cervical Collar?
A standard cervical collar supports only the neck (C1–C7). A Cervical Thoracic Orthosis (CTO) extends rigid support down into the upper thoracic spine (T1–T4), providing multi-directional immobilization that a soft or rigid collar alone cannot achieve.
The DeRoyal CTO controls motion in all planes: anterior/posterior (flexion/extension), medial/lateral (side-bending), and rotational (axial rotation) — making it the appropriate choice for unstable cervical fractures, post-operative fusion, and high thoracic injuries.
3-in-1 Modular System — How It Works
| Configuration | Typical Use |
|---|---|
| Full CTO (collar + vest + thoracic extension) | Maximum immobilization — immediately post-injury or post-surgery |
| Collar + vest (no thoracic extension) | Intermediate phase — as healing progresses and full extension is no longer required |
| Collar only | Final phase — gradual weaning from immobilization before discontinuation |
Your physician or orthotist will determine the appropriate configuration and progression schedule.
Key Features of the DeRoyal CTO
- Multi-directional support — anterior, posterior, medial, lateral, and rotational control
- 3-in-1 modular design — one system adapts throughout recovery; no need to purchase multiple braces
- Latex-safe, non-toxic open-cell foam liner — breathable; helps prevent skin breakdown and increases patient compliance
- X-ray compatible — can remain in place during imaging procedures
- Easy adjustment — simple strapping system for quick fitting and adjustment
- Replacement soft goods available — collar and vest liners can be replaced for extended use and hygiene
- Adult and pediatric sizes — Short, Regular, Tall, X-Tall (Adult); Pediatric
- FSA/HSA eligible
- HCPCS code: L0200
Clinical Indications
- Stable cervical fractures and dislocations
- Stable high thoracic fractures or dislocations
- Cervical sprains and strains
- Post-operative cervical spine stabilization
- Rheumatoid arthritis of the cervical spine
- Spondylosis
How to Measure — Chin to Shoulder Height
Measure the gap from the bottom of the chin to the top of the shoulder while the patient is seated upright with the head in a neutral position. Select the size whose range includes your measurement.
Size Chart — DeRoyal CTO Neck Brace
Select your size based on your chin-to-shoulder measurement (measured in inches from the bottom of the chin to the top of the shoulder with head in neutral position).
| Size | Chin-to-Shoulder Measurement | Part # |
|---|---|---|
| Pediatric (Extra Short) | ≤ ¼" | 11256000 |
| Adult Short | ¼" – ⅝" | 11216000 |
| Adult Regular | ⅝" – 1¼" | 11226000 |
| Adult Tall | 1¼" – 1⅞" | 11236000 |
| Adult X-Tall | ≥ 1⅞" | 11246000 |
Frequently Asked Questions — DeRoyal CTO Cervical Thoracic Orthosis
What is a cervical thoracic orthosis (CTO) and when is it prescribed?
A CTO is prescribed when a standard cervical collar provides insufficient immobilization — typically for unstable cervical fractures, post-operative cervical fusion, or high thoracic injuries. Unlike a soft or rigid collar that only supports the neck, the CTO extends rigid support into the upper thoracic spine and controls motion in all planes: flexion/extension, side-bending, and rotation. It is prescribed by a spine surgeon or orthotist and must be fitted by a trained clinician.
What does the 3-in-1 modular system mean?
The 3-in-1 system means the CTO can be configured in three ways during recovery: (1) full CTO with collar, vest, and thoracic extension for maximum immobilization immediately post-injury or post-surgery; (2) collar and vest without thoracic extension as healing progresses; and (3) collar only for the final weaning phase. This eliminates the need to purchase multiple separate braces throughout recovery.
How long do I need to wear a CTO after cervical spine surgery?
Wear duration depends on the type of surgery and your surgeon’s protocol. Most post-operative cervical fusion protocols require a CTO for 6–12 weeks, with the configuration progressively reduced as fusion is confirmed on imaging. Never modify the brace configuration or discontinue use without your surgeon’s clearance.
Is the DeRoyal CTO X-ray compatible?
Yes. The DeRoyal CTO is X-ray compatible and can remain in place during imaging procedures, eliminating the need for removal and repositioning — which is particularly important for patients with unstable fractures.
Is the DeRoyal CTO FSA or HSA eligible?
Yes. The DeRoyal CTO is a medical device and is generally FSA (Flexible Spending Account) and HSA (Health Savings Account) eligible. HCPCS code L0200 may apply — verify coverage with your insurance provider. OrthoTape does not bill insurance directly.
Shop Related Collections
Authorized DeRoyal dealer. FSA/HSA eligible. HCPCS L0200 may apply. All products are new and ship from our US warehouse. This product must be fitted by a licensed healthcare professional. OrthoTape does not provide medical advice. Questions? Call: 800-580-9887 (M–F 9:30–5:00 EST)