Prehospital Cervical Spine Motion: Immobilization Versus Spine Motion Restriction
Prehospital Emergency Care
Objective: This study aims to evaluate the efficacy of two different spinal immobilization techniques on cervical spine movement in a simulated prehospital ground transport setting.
Methods: A counterbalanced crossover design was used to evaluate two different spinal immobilization techniques in a standardized environment. Twenty healthy male volunteers (age = 20.9 ± 2.2 yr) underwent ambulance transport from a simulated scene to a simulated emergency department setting in two separate conditions: utilizing traditional spinal immobilization (TSI) and spinal motion restriction (SMR). During both transport scenarios, participants underwent the same simulated scenario. The main outcome measures were cervical spine motion (cumulative integrated motion and peak range of motion), vital signs (heart rate, blood pressure, oxygen saturation), and self-reported pain. Vital signs and pain were collected at six consistent points throughout each scenario.
Results: Participants experienced greater transverse plane cumulative integrated motion during TSI compared to SMR (F1,57 = 4.05; P = 0.049), and greater transverse peak range of motion during participant loading/unloading in TSI condition compared to SMR (F1,57 = 17.32; P < 0.001). Pain was reported by 40% of our participants during TSI compared to 25% of participants during SMR (χ2 = 1.29; P = 0.453).
Conclusions: Spinal motion restriction controlled cervical motion at least as well as traditional spinal immobilization in a simulated prehospital ground transport setting. Given these results, along with well-documented potential complications of TSI in the literature, SMR is supported as an alternative to TSI. Future research should involve a true patient population.
spinal cord, spine injury, trauma
Swartz EE, Tucker W, Nowak M, Roberto J, Hollingworth A, Decoster LC, Trimarco TW, Mihalik JP. Prehospital Cervical Spine Motion: Immobilization Versus Spine Motion Restriction. Prehospital Emergency Care. 2018; 22(5). doi: 10.1080/10903127.2018.1431341.