Cervical collars - an overview

People with craniocervical instability (CCI) or atlantoaxial instability (AAI) sometimes wear a cervical collar to limit head and neck movement when the ligaments that stabilize the upper spine are weak or injured. The collar helps by reducing strain on those ligaments, easing pressure on the brainstem and nerves, and often lessening symptoms like headache, dizziness, or neck pain.

It can also be used diagnostically — if symptoms improve while wearing it, that suggests instability is part of the problem — and therapeutically, to protect the area during healing, after surgery(fusion or decompression) or regenerative treatments (like PRP or PICL).

In this post we'll discuss the different kinds and models of cervical collars.

Soft cervical collar

Description:

• Made of foam or soft rubber, covered in fabric.

• Wraps around the neck, allowing some movement but giving gentle support.

Purpose:

• Provides warmth and mild proprioceptive feedback (reminds you not to hyperextend).

• Reduces muscle strain but doesn’t truly stabilize the upper cervical spine.

Common use:

• Short-term relief for muscle spasm, whiplash, or mild strain.

In CCI:

• Usually insufficient for meaningful stabilization.

• Might provide comfort temporarily or during acute flares, but doesn’t limit motion at C0–C2 enough to protect lax ligaments.

• Doesn't cause muscle wasting due to immobilization, so safer to use than rigid collars

Photo example of a soft collar:

Rigid/hard collars

Examples: Philadelphia collar, Miami J, Aspen Vista, Vista MultiPost, Miami J Select

Description:

• Hard plastic shell with soft liner and adjustable straps.

• Provides moderate immobilization — limits flexion, extension, rotation more than soft collars.

Purpose:

• Used after cervical surgery, trauma, or when partial immobilization is desired.

In CCI:

• Miami J and Aspen Vista are commonly used for moderate instability or for diagnostic purposes — e.g., to see if symptoms improve when the head/neck is stabilized.

• They can reduce motion at C2–C5 effectively, but upper cervical motion (C0–C1–C2) may still be partly preserved — so not a full fix for CCI involving those joints.

Pros: more support and control than soft collar, relatively comfortable for daily use.

Cons: not full immobilization, can cause muscle deconditioning/muscle wasting if worn long-term.

Example of a rigid collar:

CTO type braces

Examples:

• Aspen CTO (Cervical–Thoracic Orthosis)

• Miami J CTO

• SOMI brace (Sternal–Occipital–Mandibular Immobilizer)

• Minerva brace

Description:

• Multi-component braces that extend from the head and chin to the chest/sternum, fixing the head in space relative to the torso.

• Significantly limits flexion, extension, lateral bending, and rotation.

Purpose:

• Used in cases of more serious instability, post-operative fusion, or fractures.

In CCI:

• These braces are sometimes used for diagnostic trials: if symptoms improve dramatically while wearing a CTO or Minerva, it suggests that stabilization (fusion or regenerative) might help.

• The SOMI and Minerva braces offer the best restriction at the C0–C2 region, making them the most relevant for cranio-cervical instability. However a regular collar is often sufficient.

Pros: maximal external immobilization without surgery.

Cons: bulky, uncomfortable for long wear, may cause skin pressure or muscle weakening, difficult for daily life. Usually used temporarily.

Example of a CTO brace:

Halo vest (Halo brace)

Description:

• Metal ring (“halo”) attached to the skull with pins, connected to a vest around the torso via rods.

• Provides near-total immobilization of the head relative to the torso — used in trauma or post-op cases.

Purpose:

• Absolute immobilization after fractures, surgery, or severe instability.

In CCI:

• Rarely used outside surgical contexts because of risk (pin infection, discomfort, pressure sores).

• Sometimes used temporarily to test whether complete immobilization reduces symptoms — or after fusion surgery.

Pros: most rigid external fixation available.

Cons: invasive, uncomfortable, potential complications.

Example of a halo vest:

Custom / specialized braces

Some clinics treating CCI patients (especially those with connective-tissue disorders) prescribe, custom mold or 3D-print custom cervical orthoses that better target C0–C2 motion.

• Examples: custom-molded and/or carbon-fiber braces.

• These aim to be lighter and more targeted than full CTOs.

• Usually recommended when no standard collar fits properly

Aspen Vista brace line

The Aspen Vista series is a family of cervical and cervico-thoracic braces manufactured by Aspen Medical Products. Some key features and models:

• The basic Vista® Cervical Collar (one-size adjustable) is designed to restrict flexion/extension and some rotation of the cervical spine, via a height-adjustable plastic shell and cotton-lined pads. This goes for all collar models in this line

• The Vista® TX Collar extends down the back and front, providing additional support to the lower cervical spine

• The Vista® MultiPost Collar provides occipital(skull base) support

• The Vista® MultiPost Therapy Collar is a variation designed more for postural/therapy use (e.g., forward head posture, “text neck”, cervicogenic headaches) rather than full immobilization.

• The Vista® CTO(Cervico-Thoracic Orthosis) and Vista® CTO4 (4-post version) are higher‐restriction braces (neck + upper thorax) for more serious motion control.

More recently Aspen has come out with a new line of collars called VRTX. This line also features a Multipost, TX and CTO4 model

Aspen also makes a non adjustable collar, simply called Aspen® Cervical Collar.

Miami J brace line

The Miami J series is a family of cervical and cervico-thoracic braces manufactured by Ossur (formerly DJO/Steeper). Some key features and models:

• The Ossur Miami J ^® Cervical Collar (standard): The base version of the Miami J line. Rigid two-piece design, Sorbatex™ antibacterial padding, multiple sizes (Super Short, X-Small, Short, Regular, Tall, Stout) to match body type.

• The Ossur Miami J^® Select: A more adjustable, “universal size” version with enhanced features: tamper-proof “Left to Lock” height adjustment, anti-microbial padding, one-size-fits-most approach, convenience enhancements for fitting/adjusting.

• The Miami JTO^® Thoracic Extension provides additional fixation of the top-middle back

Philadelphia collar

The Philadelphia® Adjustable Tracheotomy Collar is a rigid cervical collar designed to immobilize the neck and upper spine while allowing access to a tracheostomy site for patients who need airway management. It also comes in a non-adjustable version.

It's a less commonly used collar although routinely recommended by some surgeons

Eclipse Cervical Collar

The Eclipse^® Cervical Collar is a semi-rigid cervical orthosis produced by Eclipse (via VQ OrthoCare) for use in mild to severe neck injuries, post-surgery, and stabilization of the cervical spine. It's one-size and adjustable. It comes in a EXT version with an extended back panel. It's a newer brace that's rarely used in a hospital setting but liked by some CCI patients

Minerva vest/brace

The Minerva is not a specific brand of brace, but rather a type. It's a cervico-thoracic brace, that often features a strap around the forehead. It's usually made of metal, which makes it differ from other braces that are most often made from a type of plastic. The minerva is adjustable, unless its custom molded.

One of the commonly used brands are ottobock.

Which collar will fit me?

It's impossible to predict which collar will be a good fit for the individual person. The best approach is to see an orthotist, often they have multiple options to try out, or can order them for you. They will also professionally fit the collar to you, help you with how to put it on and how to care for it. This solution ensures that you're not hurting yourself by wearing a poorly fitting collar.

Remember that wearing a collar wrong or too much can cause more harm than good. For this reason you should always talk to a doctor before you start wearing one.

This concludes our collar overview. Feel free to comment below if you have any input or any questions!