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Remaining Cervical Spine Movement Under Different Immobilization Techniques

Published online by Cambridge University Press:  20 May 2020

Davut D. Uzun ,
Matthias K. Jung ,
Jeronimo Weerts ,
Matthias Münzberg ,
Paul A. Grützner ,
David Häske  and
Michael Kreinest Open the ORCID record for Michael Kreinest [Opens in a new window]
Davut D. Uzun
Affiliation:
Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
Matthias K. Jung
Affiliation:
Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
Jeronimo Weerts
Affiliation:
Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Berlin, Germany
Matthias Münzberg
Affiliation:
Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany Centre of Rescue- and Emergency Medicine, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
Paul A. Grützner
Affiliation:
Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
David Häske
Affiliation:
Faculty of Medicine, Eberhard Karls University Tübingen, Tuebingen, Germany DRK Rettungsdienst Reutlingen, Reutlingen, Germany
Michael Kreinest*
Affiliation:
Department of Trauma and Orthopedic Surgery, BG Trauma Centre Ludwigshafen, Ludwigshafen, Germany
*
Correspondence: Michael Kreinest, MD, PhD, Department of Trauma and Orthopedic Surgery, BG Hospital Ludwigshafen, 67071Ludwigshafen, Germany, E-mail: michael.kreinest@bgu-ludwigshafen.de
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Abstract

Background:

Immobilization of the cervical spine by Emergency Medical Services (EMS) personnel is a standard procedure. In most EMS, multiple immobilization tools are available.

The aim of this study is the analysis of residual spine motion under different types of cervical spine immobilization.

Methods:

In this explorative biomechanical study, different immobilization techniques were performed on three healthy subjects. The test subjects’ heads were then passively moved to cause standardized spinal motion. The primary endpoints were the remaining range of motion for flexion, extension, bending, and rotation measured with a wireless human motion detector.

Results:

In the case of immobilization of the test person (TP) on a straight (0°) vacuum mattress, the remaining rotation of the cervical spine could be reduced from 7° to 3° by additional headblocks. Also, the remaining flexion and extension were reduced from 14° to 3° and from 15° to 6°, respectively. The subjects’ immobilization was best on a spine board using a headlock system and the Spider Strap belt system (MIH-Medical; Georgsmarienhütte, Germany). However, the remaining cervical spine extension increased from 1° to 9° if a Speedclip belt system was used (Laerdal; Stavanger, Norway). The additional use of a cervical collar was not advantageous in reducing cervical spine movement with a spine board or vacuum mattress.

Conclusions:

The remaining movement of the cervical spine is minimal when the patient is immobilized on a spine board with a headlock system and a Spider Strap harness system or on a vacuum mattress with additional headblocks. The remaining movement of the cervical spine could not be reduced by the additional use of a cervical collar.

Keywords

cervical collarcervical spineEmergency Medical Serviceimmobilizationspine board

Information

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 4 , August 2020 , pp. 382 - 387
Copyright
© World Association for Disaster and Emergency Medicine 2020

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Footnotes

Uzun and Jung contributed equally to the current manuscript.

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