A comparison of three cervical immobilization devices

Abstract

Objective: Prehospital cervical spinal cord injuries (SCIs) are rare but potentially catastrophic. Although spinal immobilization is resource-intensive, emergency medical services (EMS) personnel commonly immobilize trauma patients to prevent exacerbation of unrecognized SCI during transport. We compared the stabilization properties of a novel rigid, cervical immobilization collar (XCollar) with those of one-piece and two-piece rigid collars commonly used in the prehospital setting.

Methods: This was a prospective laboratory study of healthy adult volunteers to determine total cervical motion in the horizontal, coronal, and sagittal planes in both seated and supine positions. Goniometric techniques were used to measure head and neck movement after marking anatomic landmarks. Ranges of motion were compared with a one-way analysis of variance (ANOVA). A Bonferroni correction was applied for multiple comparisons, setting significance at p <or= 0.004.

Results: Twenty-five subjects (11 men; 14 women) completed the study. The subject pool represented a wide range of morphometrics. For most measurements, the XCollar permitted 10-15 millimeters of movement when applied without manual cervical stabilization. This was less than the movement permitted by both comparison collars. On average, the XCollar permitted less than 10 millimeters of movement in the sagittal and horizontal planes when the subject was in the seated position.

Conclusions: The XCollar provided superior cervical stabilization without augmentation by manual stabilization in healthy adult volunteers in both the seated and supine positions when compared with other one-piece and two-piece rigid cervical collars. Although maximal stabilization was achieved only after the subjects were secured to a long spine board with a cervical immobilization device, the XCollar can provide an acceptable alternative to manual cervical stabilization in situations where the number of patients exceeds the number of EMS providers available to provide care.