Introduction to Scanning for Spinals

Spinals by Scanning

Weighing the Options

Direct Scanning Clinical Options Casting Patient By Measurement Only Using Scanner Spinal Applications

Direct Scanning of Patient

Spinal Scanning Modification Scanning Preparing Patient Fabrication

Preparing the patient; scanning techniques Scanning Spinals

Preparing Patient Positioning Target & Landmarks Measurements Spinal Scanning

Preparing Patient Positioning Targets & Landmarks Measurements Standing vs. Lying Down 1-Part vs. 2-Part 1-Part Options2-Part Options Entire torso Scan half & mirror Anterior/ Posterior Left/ Right Spinal Scanning

2-Part Scans: Anterior/Posterior

2-Part Scans: Left/Right

1-Part Scanning & Mirroring

Preparing Patient Positioning Targets & Landmarks Measurements Anatomical Landmarks Reference Landmarks (2-Part Scans only) Sternal NotchAxilla XyphoidWaist Rt. & Lt. WaistASIS Rt. & Lt. ASIS Pubis Lumbar AreaMid Scapular Level Set of 3 common landmarks in each scan Spinal Scanning

Preparing Patient Positioning Targets & Landmarks Measurements Anatomical Landmarks Reference Landmarks (2-Part Scans only) Spinal Scanning

Preparing Patient Positioning Targets & Landmarks Measurements Anatomical Landmarks Reference Landmarks (2-Part Scans only) Spinal Scanning

Preparing Patient Positioning Targets & Landmarks Measurements Anatomical Landmarks Reference Landmarks (2-Part Scans only) Spinal Scanning

Preparing Patient Positioning Targets & Landmarks Measurements Compressed or passive? Orthometry Form Should I still take measurements? Standing vs. lying down Electronic YES Clinician Preference Spinal Scanning

LandmarkLocate & LabelWidthsCircDistances Sternal Notch  REC NA OPT Axilla  REC OPT Nipple LineOPT Xyphoid  REC OPT Lower RibOPT **Waist**  REC OPT ASIS  REC OPT Pubis  REC OPT **Note: Recommend taking passive and compressed measurements at waist Patient Measurements

Scanning Inspect Scan Merging & Aligning of 2-Part Scan Alignment of Complete Scan Preparing Patient Spinal Scanning

Scanning Inspect Scan Merging & Aligning of 2-Part Scan Alignment of Complete Scan Preparing Patient EraseRemove Groups Knife Plane Spinal Scanning

Scanning Inspect Scan Merging & Aligning of 2-Part Scan Alignment of Complete Scan Preparing Patient PosteriorAnteriorLeftRight Spinal Scanning

2-Part Scans: Anterior/Posterior

2-Part Scans: Left/Right

Scanning Inspect Scan Merging & Aligning of 2-Part Scan Alignment of Complete Scan Preparing Patient Fine Alignment of the 2-Part Scan Spinal Scanning

Correcting Rotation of SCAN 1-RED (anterior scan) using TILT from a distal view Correcting Rotation of SCAN 1-RED (anterior scan) by using TILT

Correcting Lateral Tilt of SCAN 1-RED (anterior scan) using TILT from the anterior view Correcting A/P depth by moving SCAN 2-BLUE (posterior scan) using SHIFT from a lateral view

Scanning Inspect Scan Merging & Aligning of 2-Part Scan Alignment of Complete Scan Preparing Patient Edit Landmarks Trimming Model Most Distal Most Proximal Positioning of vertical axis Fine Tuning Anterior or Posterior View Lateral View Anterior Orientation Initial - Anterior Fine Tuning Anterior View Distal View Spinal Scanning

Setting Initial Anterior Alignment Fine Alignment Anterior View Fine Alignment Lateral View Fine Alignment of Distal View

Most DistalMost Proximal After Cutting

Predefined Relief PadRequired Landmark Sternal CompressionSternal Notch Posterior Proximal ContouringMid Scapular Level Lt. & Rt. Costal Margin BuildupXyphoid Lt. & Rt. Waist GrooveLT. & RT. Waist Abdominal CompressionWaist Lt. & Rt. Iliac Crest BuildupLT. & RT. Waist Lumbar PadLumbar Area Editing Landmarks

Practical Application

Scanning ModificationModification Wizard vs. Tool Menu selections Preparing Patient Spinal Scanning

Scanning ModificationModification Wizard vs. Tool Menu selections Preparing Patient Tool Menu Selections The ability to pick and choose modification tools and/or tool groups independently from the main tool menu. Modification Wizards Predefined series of modification steps that the user is prompted through. Wizards are automatically provided with the OMEGA system software, but the user also has the ability to build and save custom wizards. Spinal Scanning

Scanning ModificationModification Wizard vs. Tool Menu Selections Preparing Patient Tool Menu Selections Modification Wizards Spinal by Measurement Male Female Spinal by Scanning Male Female Spinal Scanning

Four wizards Spinal By Scanning – Male Spinal By Scanning – Female Spinal By Measurement – Male Spinal By Measurement – Female Difference between Male and Female wizards – Female wizards have Breast Height & Cup Size tools Difference between Scanning and By Measurement wizards – Scanning wizards have Blend Sides tool Spinal Modification Wizards

Scanning ModificationModification Wizard vs. Tool Menu Selections Preparing Patient Tool Menu Selections Modification Wizards Spinal Tool Page Bending Cutting Breast Alignment Individual Tools All tools for all models Spinal Scanning

Tool Menu Selections Spinal Tool Page Individual Tools

Tool Menu Selections Spinal Tool Page Individual Tools

Template Selection & Shape Creation Fabrication Prepare & Measure General C-FabOn-Site Carver Modification OMEGA C-Fab Spinal by Measurement

Spinals by Measurement

Effectively Accommodates For Varying Anatomical Shapes

Appropriate for: – Pediatric – Adult – Geriatric – TLSO – LSO Applications

Effectively Accommodates For Varying Anatomical Shapes

No uncomfortable casting process means increased patient comfort Electronic copy of every patient shape Provides an effective and cleaner method Convenience and efficiency of using off site fabrication while having complete control over the finished shape Eliminates maneuvering heavy positive models Benefits

Spinal by Measurement Fabrication Modification Template Selection and Shape Creation Preparing Patient and Taking Measurements

Spinal by Measurement Preparing Patient and Taking Measurements

Prepare & Measure Anatomical Landmarks Measurements Sternal NotchAxilla XyphoidWaist ASISPubis &/or Trochanter Nipple Line Trimline Levels Lumbar AreaMid Scapular Level Spinal by Measurements

Prepare & Measure Anatomical Landmarks Measurements Compressed or passive? Orthometry Form Standing vs. lying down Electronic Clinician Preference Spinal by Measurements

Landmarks & Measurements

LandmarkLocate & LabelWidthsCircDistances Sternal Notch  REC NA OPT Axilla  REC OPT Nipple LineOPT Xyphoid  REC OPT Lower RibOPT **Waist**  REC OPT ASIS  REC OPT Pubis  REC OPT **Note: Recommend taking passive and compressed measurements at waist Patient Measurements

Effectively Accommodates For Varying Anatomical Shapes

Circumferences M/L Distances Spacing Which measurements used to "Create" shape Which measurements used for fine tuning with spinal tools Measurements

Not applying the chest circumference during the initial “create” process of a female shape Making symmetrical modifications Golden Rules

Linear vs. Surface Height measurements Length measurements that follow the contour of surfaces with a significant curvature will be longer than a straight line Locking posterior contour Applying Measurements

Spinal by Measurement Template Selection and Shape Creation Preparing Patient and Taking Measurements

Using Templates: Demonstration

What are they? How are they made? How are they used? Templates

More than 800 templates available Use the Spinal Template Search feature Finding the Right Template

Why is a large template library important? How to make a template? Modify an existing template Save any patient file as a template Trace a modified positive model Scan a modified positive model Internally trace a spinal orthosis or inner surface of a negative wrap from a modified shape Creating Your Own Templates

Spinal by Measurement Modification Template Selection and Shape Creation Preparing Patient and Taking Measurements

Template Selection & Shape Creation Prepare & Measure Modification Modification Wizard vs. Tool Menu Selections Spinal by Measurement

Template Selection & Shape Creation Prepare & Measure Modification Modification Wizard vs. Tool Menu Selections Tool Menu Selections The ability to pick and choose modification tools and/or tool groups independently from the main tool menu. Modification Wizards Predefined series of modification steps that the user is prompted through. Wizards are automatically provided with the OMEGA system software, but the user also has the ability to build and save custom wizards. Spinal by Measurement

Scanning ModificationModification Wizard vs. Tool Menu Selections Preparing Patient Tool Menu Selections Modification Wizards Spinal by Measurement Male Female Spinal by Scanning Male Female Spinal Scanning

Four wizards Spinal By Scanning – Male Spinal By Scanning – Female Spinal By Measurement – Male Spinal By Measurement – Female Difference between Male and Female wizards – Female wizards have Breast Height & Cup Size tools Difference between Scanning and By Measurement wizards – Scanning wizards have Blend Sides tool Spinal Modification Wizards

Symmetry accuracy Custom & Predefined Relief Pads Lordosis Kyphosis Breast area modifications Trimlines Modification Needs and Tools for Spinals

Spinal by Measurement Fabrication Modification Template Selection and Shape Creation Preparing Patient and Taking Measurements

Template Selection & Shape Creation Fabrication Prepare & Measure General C-FabOn-Site Carver Modification OMEGA C-Fab Spinal by Measurement

Custom Modification Wizards

Insole AFO Spinal Custom Modification Wizards

Create your own modification wizard You can select which tools you wish to be included and in what order they occur Custom Modification Wizards

Creating Templates

What is a template? – A pre-modified shape, essentially a socket shape, that is resized by applying patient measurements Clinical considerations – By Measurement vs. Shape Capture Is the patient’s residual limb uniformly contoured? Does it have an irregularly shaped distal end? Does it have a shape not represented by any of the templates available?

Modifying existing template files – To replace the existing template or create a new template Saving finished patient files as templates – Important to Save patient file first, then use Save Patient File as Template and name accordingly Creating Templates From an Electronic File

Suggested method is to have a poured model of socket you wish to make into a template Identify Anatomical Landmarks – Most important aspect to remember! – MUST be accurately identified on the model before you begin Creating Templates From a Plaster Model

Scan models using MODEL ONLY to bypass merging or modifications Creating Templates by Scanning

Take length measurement with a straight edge ruler with patient’s hip in extension While the straight edge measuring device is in place, mark levels for circumferential measurements Take & record circumferential measurements Record all measurements in the Electronic Orthometry Form (EOF) Measuring the Patient

Symmetry accuracy Custom & Predefined Relief Pads Lordosis Kyphosis Breast area modifications Trimlines Modification Needs and Tools for Spinals

Spinal Tool Page Adjust Tool Shift Area Relief Pad Making cutout – Fixed Build Height + Fill Smoothing option Creating and saving trimlines Adjusting heights with Extend Skeletal Fit Advanced Dual Model View & Set/Peek options Additional Spinal Tools and Modification Techniques

Available in PDF form Click on any item in Table of Contents or Index to go to desired page Manuals