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Using a Clamshell Brace to Treat Spinal Cord Injury


  • A clamshell brace is a brace used to hold the thoracic (chest) part of your spine immobile. This means that the part of your spine in your chest will not move and will stay in the correct position. This allows your injured spinal column and the ligaments to heal. This brace keeps your spine from flexing (moving forward), extending (bending backward) or rotating (turning). A clamshell brace may enclose your entire torso (chest to waist), or only part of your torso. This is important because staying in bed may cause many pressure sores, blood clots, and other health problems. The clamshell brace lets you get out of bed and start moving sooner.
  • The clamshell brace fits tightly over your back, chest, and hips like having a cast on an arm or a leg. It is made up of front and back pieces of plastic that mold to your chest. The two pieces are lined with foam and are connected together with straps. There are holes in the two pieces to help keep you cool. A clamshell brace may enclose your entire torso (chest to waist), or only part of your torso.



  • Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  • Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

Ask your caregiver when to return for a follow-up visit.

Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Dos and do nots of having a clamshell brace:

  • Do: Always lay flat if the vest needs to be opened for any reason.
  • Do: Always have someone check the vest before getting out of bed.
  • Do: Always wear a tee shirt under the vest.
  • Do: Tell your caregiver if you have back pain or if you think the vest is too loose or too tight. Stay flat in bed until your medical caregivers check the vest and tighten it correctly.
  • Do not: Never open the vest unless you are lying flat.
  • Do not: Never put lotion on or under the tee shirt because this can cause skin problems.
  • Do not: Never allow anyone to adjust the vest unless they are trained to do so.

How do I care for the clamshell brace?

Taking care of your clamshell brace includes checking the skin under the vest, and making sure the vest is on correctly.

  • Correct clamshell placement: It is very important to have your clamshell brace on correctly. If it is too loose or too tight, your spine may not be lined up correctly, which could cause serious problems. Caregivers will check your clamshell brace regularly. Tell them if you feel that the vest is too loose or too tight. Caregivers will correctly fit it to you as soon as possible. Follow these instructions to put your clamshell vest on correctly. Ask for help so that you make sure not to twist or bend.
    • Lie on your back. Put both halves of the clamshell, and a clean, dry tee shirt within easy reach.
    • Log roll onto your side. This means that you roll with your entire body in a straight line. Do not let your hips, legs, shoulders, or head move before or after the rest of your body.
    • Put the back half of the brace behind you with the waist indentation right above your hip bones. Put the back portion as far under you as possible.
    • Put a clean, dry tee shirt on over your head and arm. Pull the shirt down in front.
    • Push down on the front part of the clamshell as you roll onto your back to keep the back part from moving.
    • Put the top half of the clamshell on and line up the buckles.
    • Tighten the straps to make the clamshell fit snugly.
    • Log roll onto your stomach and then unhook the clamshell straps.
    • Remove the back half of the clamshell vest and pull down your tee shirt.
    • Replace the back half of the clamshell and secure the straps.
    • Sit up and check to make sure the tee shirt is not bunched or wrinkled. This could cause pressure sores.
  • Skin care:
    • Have a family member or caregiver check your skin in the morning and the evening every day. Lie flat on the bed before opening the vest. Caregivers may put a gel pad on any reddened areas to relieve pressure of the vest on your skin.
    • You can take a shower with the vest on. After showering, lie down to put on a clean dry tee shirt. Sit up after replacing the vest and make sure that the tee shirt is not bunched or wrinkled.

Where can I go for support?

  • Having a spinal cord injury is life changing for you and your family. Accepting that you have a spinal cord injury is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with a spinal cord injury.
  • You may want to join a support group. This is a group of people who also have spinal cord injuries. Ask your caregiver for the names and numbers of support groups in your town. You can contact one of the following national organizations for more information.
    • Paralyzed Veterans of America
      801 Eighteenth Street NW
      Washington, DC , 20006
      Phone: 1- 800 - 424-8200
      Web Address:
    • National Spinal Cord Injury Association
      6701 Democracy Blvd, Ste 300-9
      Bethesda , MD 20817
      Phone: 1- 800 - 962-9629
      Web Address:
    • American Spinal Cord Association
      2020 Peachtree Road, NW
      Atlanta, Georgia , 30309-1402
      Phone: 1- 404 - 355-9772
      Web Address:


  • You have back pain.
  • You have signs of a pressure sore under the vest, such as a red, painful, or open area of skin.


  • You feel the brace is too tight or too loose. Lay down flat after contacting your caregiver until your clamshell brace can be checked.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Using a Clamshell Brace to Treat Spinal Cord Injury (Discharge Care)

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.