Total Motion Generated in the Unstable Cervical Spine During Management of the Typical Trauma Patient

Prasarn, Mark L.; Horodyski, MaryBeth; Dubose, Dewayne; Small, John; Rossi, Gianluca Del; Zhou, Haitao; Conrad, Bryan P.; Rechtine, Glenn R.

doi:10.1097/brs.0b013e31823765af

Cited by 16 publications

(5 citation statements)

References 17 publications

(3 reference statements)

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“…Our group has previously evaluated various spine-boarding transfer techniques. 6 – 9 , 14 , 23 , 24 Results of these studies support our current findings and suggest that the lifting techniques may be a better alternative to the LR. Del Rossi et al 7 specifically looked at these 3 methods of spine boarding and found less motion with the use of lifting techniques as compared with the LR.…”

Section: Discussionsupporting

confidence: 88%

“…In a later study examining typical movements and transfers of a trauma patient, in addition to spine boarding, it was again shown that the LR results in additional motion at an unstable cervical spine injury. 23 These studies did not evaluate the maneuvers with protective football equipment in place. Dealing with such a situation requires proper training and possibly alternative techniques.…”

Section: Discussionmentioning

confidence: 99%

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Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine

Prasarn

Horodyski

DiPaola

et al. 2015

Orthopaedic Journal of Sports Medicine

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BackgroundNumerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board.PurposeTo test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model.Study DesignControlled laboratory study.MethodsFive whole, lightly embalmed cadavers were fitted with shoulder pads and helmets and tested both before and after global instability was surgically created at C5-C6. An electromagnetic motion analysis device was used to assess the amount of angular and linear motion with sensors placed above and below the injured segment during transfer. Spine-boarding techniques evaluated were the log roll, the lift and slide, and the 8-person lift.ResultsThe 8-person lift technique resulted in the least amount of angular and linear motion for all planes tested as compared with the lift-and-slide and log-roll techniques. This reached statistical significance for lateral bending (P = .031) and medial-lateral translation (P = .030) when compared with the log-roll maneuver. The lift-and-slide technique was significantly more effective at reducing motion than the log roll for axial rotation (P = .029) and lateral bending (P = .006).ConclusionThe log roll resulted in the most motion at an unstable cervical injury as compared with the other 2 spine-boarding techniques examined. The 8-person lift and lift-and-slide techniques may both be more effective than the log roll at reducing unwanted cervical spine motion when spine boarding an injured football player. Reduction of such motion is critical in the prevention of iatrogenic injury.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine

Prasarn

Horodyski

DiPaola

et al. 2015

Orthopaedic Journal of Sports Medicine

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“…In two recent studies, for both a cervical[19] and thoracolumbar injury,[20] we evaluated the cumulative effects of repeated log roll maneuvers during sequential stages of trauma management. Each of these studies tested the motion that occurred during spine board placement, spine board removal, bed transfers, lateral therapy, and prone positioning in the operating room.…”

Section: Resultsmentioning

confidence: 99%

“…to different diagnostic locations and imaging facilities), making this an important phase of care to be evaluated. The studies by Prasarn and colleagues[1920] analyzed the motion that occurs when a patient is transferred between hospital beds. One common practice for performing bed transfers is to log roll the patient onto a transfer board (sliding board or roller board) and then shift the patient from one bed to the adjacent bed.…”

Section: Resultsmentioning

confidence: 99%

Eliminating log rolling as a spine trauma order

Conrad¹,

Rossi²,

Horodyski³

et al. 2012

Surg Neurol Int

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Background:Currently, up to 25% of patients with spinal cord injuries may experience neurologic deterioration during the initial management of their injuries. Therefore, more effective procedures need to be established for the transportation and care of these to reduce the risk of secondary neurologic damage. Here, we present more acceptable methods to minimize motion in the unstable spine during the management of patients with traumatic spine injuries.Methods:This review summarizes more than a decade of research aimed at evaluating different methods of caring for patients with spine trauma.Results:The most commonly utilized technique to transport spinal cord injured patients, the log rolling maneuver, produced more motion than placing a patient on a spine board, removing a spine board, performing continuous lateral therapy, and positioning a patient prone for surgery. Alternative maneuvers that produced less motion included the straddle lift and slide, 6 + lift and slide, scoop stretcher, mechanical kinetic therapy, mechanical transfers, and the use of the operating table to rotate the patient to the prone position for surgical stabilization.Conclusions:The log roll maneuver should be removed from the trauma response guidelines for patients with suspected spine injuries, as it creates significantly more motion in the unstable spine than the readily available alternatives. The only exception is the patient who is found prone, in which case the patient should then be log rolled directly on to the spine board utilizing a push technique.

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“…This can be done for example by placing the mattress on a scoop stretcher. Because the mattress can be folded around the body, immobilisation is superior to that achieved using a spineboard, both objectively [62,[65][66][67][68] and subjectively [66,68].…”

Section: Advantages and Disadvantages Of Using A Spineboard Or Vacuum Mattressmentioning

confidence: 99%

Improving spineboard design

Hemmes¹

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Total Motion Generated in the Unstable Cervical Spine During Management of the Typical Trauma Patient

Cited by 16 publications

References 17 publications

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine

Eliminating log rolling as a spine trauma order

Improving spineboard design

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