Which cervical orthosis attaches to the skull by screws and provides maximum cervical spine control?

• A. Halo orthosis
• B. Minerva orthosis
• C. Cervical - Four-poster orthosis
• D. Soft collar

Answer: (C)

Rigid immobilization of the cervical spine depends on where the device fixes the head. The halo orthosis achieves the highest level of control because it fixes directly to the skull with transcranial pins and connects to a vest, creating a single rigid unit that limits movement in all directions at the upper cervical levels. This makes it the go-to choice for unstable injuries or procedures needing maximal stability.

In contrast, the four-poster cervical orthosis relies on uprights and a vest to restrict motion but does not secure the head to the skull with pins, so its immobilization is substantial but not as rigid as a halo. The Minerva orthosis offers rigid immobilization as well but attaches differently and generally does not achieve the same level of control as a halo. A soft collar provides only minimal immobilization and is used for non-severe cases or initial stabilization.