Remaining Cervical Spine Movement Under Different Immobilization Techniques

2020 ◽  
Vol 35 (4) ◽  
pp. 382-387 ◽  
Author(s):  
Davut D. Uzun ◽  
Matthias K. Jung ◽  
Jeronimo Weerts ◽  
Matthias Münzberg ◽  
Paul A. Grützner ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Standard Procedure ◽  
Human Motion ◽  
Cervical Collar ◽  
Vacuum Mattress ◽  
Flexion Extension ◽  
Immobilization Techniques ◽  
Spine Board ◽  
Spine Movement ◽  
Belt System

AbstractBackground: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.

Cervical Spine Movement Sequencing During Flexion-Extension

2011 ◽  
Author(s):  
William J. Anderst ◽  
Michelle Schafman ◽  
William F. Donaldson ◽  
Joon Y. Lee ◽  
James D. Kang
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Daily Living ◽  
X Rays ◽  
Clinical Tool ◽  
Normal Range ◽  
Kinematic Data ◽  
Flexion Extension ◽  
Functional Movements ◽  
Spine Movement

Static flexion-extension x-rays are the most common clinical tool used to assess abnormal motion of the cervical spine. Despite their widespread use (over 168,000 cases per year), the clinical efficacy of flexion-extension radiographs of the cervical spine has yet to be proven1. Limitations of static flexion-extension x-rays include data collection during static positions that may not accurately represent dynamic behavior, and the fact that data is collected at end range of motion positions, not in more frequently encountered mid-range positions. Consequently, static x-rays may not reveal movement abnormalities that occur during activities of daily living and lead to pain and degeneration. Therefore, it may be advantageous to analyze cervical spine kinematic data collected during dynamic, functional movements performed through an entire range of motion (not just the endpoints). Furthermore, the literature confirms there is substantial variability in “normal” range of motion and translation during flexion-extension1, making it difficult to reliably identify abnormal motion. Therefore, it may also be beneficial to evaluate alternative motion parameters that may reliably identify abnormal motion.

Cervical Spine Movement Using the Motorized Spine Board vs. Other Recommended Techniques

2007 ◽  
Vol 39 (Supplement) ◽  
pp. S320
Author(s):  
Douglas M. Kleiner ◽  
MaryBeth Horodyski ◽  
Bryan P. Conrad ◽  
Glenn R. Rechtine
Keyword(s):  
Cervical Spine ◽  
Spine Board ◽  
Spine Movement

scholarly journals Analysis of remaining motion using one innovative upper airway opening cervical collar and two traditional cervical collars

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Matthias K. Jung ◽  
Gregor V. R. von Ehrlich-Treuenstätt ◽  
Holger Keil ◽  
Paul A. Grützner ◽  
Niko R. E. Schneider ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Upper Airway ◽  
Cervical Collar ◽  
Lateral Bending ◽  
Significant Difference ◽  
Airway Opening ◽  
Human Cadavers ◽  
The Mean ◽  
Immobilization Techniques

AbstractThe aim of this study was to compare the remaining motion of an immobilized cervical spine using an innovative cervical collar as well as two traditional cervical collars. The study was performed on eight fresh human cadavers. The cervical spine was immobilized with one innovative (Lubo Airway Collar) and two traditional cervical collars (Stifneck and Perfit ACE). The flexion and lateral bending of the cervical spine were measured using a wireless motion tracker (Xsens). With the Weinman Lubo Airway Collar attached, the mean remaining flexion was 20.0 ± 9.0°. The mean remaining flexion was lowest with the Laerdal Stifneck (13.1 ± 6.6°) or Ambu Perfit ACE (10.8 ± 5.8°) applied. Compared to that of the innovative Weinmann Lubo Airway Collar, the remaining cervical spine flexion was significantly decreased with the Ambu Perfit ACE. There was no significant difference in lateral bending between the three examined collars. The most effective immobilization of the cervical spine was achieved when traditional cervical collars were implemented. However, all tested cervical collars showed remaining motion of the cervical spine. Thus, alternative immobilization techniques should be considered.

scholarly journals Investigation into Cervical Spine Biomechanics Following Single, Multilevel and Hybrid Disc Replacement Surgery with Dynamic Cervical Implant and Fusion: A Finite Element Study

2022 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Muzammil Mumtaz ◽  
Iman Zafarparandeh ◽  
Deniz Ufuk Erbulut
Keyword(s):  
Cervical Spine ◽  
Standard Procedure ◽  
Total Disc Replacement ◽  
Disc Replacement ◽  
Von Mises Stress ◽  
Adjacent Segment ◽  
Fusion Model ◽  
Hybrid Surgery ◽  
Maximum Increase ◽  
Flexion Extension

Cervical fusion has been a standard procedure for treating abnormalities associated with the cervical spine. However, the reliability of anterior cervical discectomy and fusion (ACDF) has become arguable due to its adverse effects on the biomechanics of adjacent segments. One of the drawbacks associated with ACDF is adjacent segment degeneration (ASD), which has served as the base for the development of dynamic stabilization systems (DSS) and total disc replacement (TDR) devices for cervical spine. However, the hybrid surgical technique has also gained popularity recently, but its effect on the biomechanics of cervical spine is not well researched. Thus, the objective of this FE study was to draw a comparison among single-level, bi-level, and hybrid surgery with dynamic cervical implants (DCIs) with traditional fusion. Reductions in the range of motion (ROM) for all the implanted models were observed for all the motions except extension, compared to for the intact model. The maximum increase in the ROM of 42% was observed at segments C5–C6 in the hybrid DCI model. The maximum increase in the adjacent segment’s ROM of 8.7% was observed in the multilevel fusion model. The maximum von Mises stress in the implant was highest for the multilevel DCI model. Our study also showed that the shape of the DCI permitted flexion/extension relatively more compared to lateral bending and axial rotation.

Comparison of the Vacuum Mattress versus the Spine Board Alone for Immobilization of the Cervical Spine Injured Patient

Spine ◽  
2017 ◽  
Vol 42 (24) ◽  
pp. E1398-E1402 ◽  
Author(s):  
Mark L. Prasarn ◽  
Per Kristian Hyldmo ◽  
Laura A. Zdziarski ◽  
Evan Loewy ◽  
Dewayne Dubose ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Injured Patient ◽  
Vacuum Mattress ◽  
Spine Board

scholarly journals A Comparison of Cervical Spine Motion After Immobilization With a Traditional Spine Board and Full-Body Vacuum-Mattress Splint

2017 ◽  
Vol 5 (12) ◽  
pp. 232596711774475 ◽  
Author(s):  
Brian E. Etier ◽  
Grant E. Norte ◽  
Megan M. Gleason ◽  
Dustin L. Richter ◽  
Kelli F. Pugh ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Athletic Trainers ◽  
Transverse Plane ◽  
Vacuum Mattress ◽  
Football Helmet ◽  
Tilt Condition ◽  
Spine Motion ◽  
Testing Condition ◽  
Spine Board ◽  
Full Body

Background: The National Athletic Trainers’ Association (NATA) advocates for cervical spine immobilization on a rigid board or vacuum splint and for removal of athletic equipment before transfer to an emergency medical facility. Purpose: To (1) compare triplanar cervical spine motion using motion capture between a traditional rigid spine board and a full-body vacuum splint in equipped and unequipped athletes, (2) assess cervical spine motion during the removal of a football helmet and shoulder pads, and (3) evaluate the effect of body mass on cervical spine motion. Study Design: Controlled laboratory study. Methods: Twenty healthy male participants volunteered for this study to examine the influence of immobilization type and presence of equipment on triplanar angular cervical spine motion. Three-dimensional cervical spine kinematics was measured using an electromagnetic motion analysis system. Independent variables included testing condition (static lift and hold, 30° tilt, transfer, equipment removal), immobilization type (rigid, vacuum-mattress), and equipment (on, off). Peak sagittal-, frontal-, and transverse-plane angular motions were the primary outcome measures of interest. Results: Subjective ratings of comfort and security did not differ between immobilization types ( P > .05). Motion between the rigid board and vacuum splint did not differ by more than 2° under any testing condition, either with or without equipment. In removing equipment, the mean peak motion ranged from 12.5° to 14.0° for the rigid spine board and from 11.4° to 15.4° for the vacuum-mattress splint, and more transverse-plane motion occurred when using the vacuum-mattress splint compared with the rigid spine board (mean difference, 0.14 deg/s [95% CI, 0.05-0.23 deg/s]; P = .002). In patients weighing more than 250 lb, the rigid board provided less motion in the frontal plane ( P = .027) and sagittal plane ( P = .030) during the tilt condition and transfer condition, respectively. Conclusion: The current study confirms similar motion in the vacuum-mattress splint compared with the rigid backboard in varying sized equipped or nonequipped athletes. Cervical spine motion occurs when removing a football helmet and shoulder pads, at an unknown risk to the injured athlete. In athletes who weighed more than 250 lb, immobilization with the rigid board helped to reduce cervical spine motion. Clinical Relevance: Athletic trainers and team physicians should consider immobilization of athletes who weigh more than 250 lb with a rigid board.

scholarly journals Investigation Into Cervical Spine Biomechanics Following Single, Multilevel and Hybrid Disc Replacement Surgery With Dynamic Cervical Implant and Fusion: A Finite Element Study

2021 ◽  
Author(s):  
Muzammil Mumtaz ◽  
Iman Zafarparandeh ◽  
Deniz Ufuk Erbulut
Keyword(s):  
Cervical Spine ◽  
Standard Procedure ◽  
Total Disc Replacement ◽  
Disc Replacement ◽  
Von Mises Stress ◽  
Adjacent Segment ◽  
Fusion Model ◽  
Hybrid Surgery ◽  
Maximum Increase ◽  
Flexion Extension

Cervical fusion has been a standard procedure for treating the abnormalities associated with the cervical spine. However, the reliability of anterior cervical discectomy and fusion (ACDF) has become arguable due to its adverse effects on the biomechanics of adjacent segments. One of the drawbacks associated with ACDF is adjacent segment degeneration (ASD) which has served as the base for the development of dynamic stabilization systems (DSS) and total disc replacement (TDR) devices for cervical spine. However, the hybrid surgical technique has also gained popularity recently but their effect on the biomechanics of cervical spine is not well researched. Thus, the objective of this FE study was to draw the comparison among single, bi-level and hybrid surgery with DCI implant with traditional fusion. Reduction in range of motion (ROM) for all the implanted models was observed for all the motions except extension, compared to intact model. The maximum increase in ROM of 42% was observed at C5-C6 level in Hybrid-DCI model. The maximum increase in adjacent segment’s ROM of 8.7% was observed in multilevel fusion model. The maximum von Mises stress in the implant was highest for the multilevel DCI model. Our study also showed that the shape of DCI implant permits flexion/extension relatively more compared to lateral bending and axial rotation.

Comparison of the Bullard and Macintosh Laryngoscopes for Endotracheal Intubation of Patients with a Potential Cervical Spine Injury 

1997 ◽  
Vol 87 (6) ◽  
pp. 1335-1342 ◽  
Author(s):  
Andrew D. J. Watts ◽  
Adrian W. Gelb ◽  
David B. Bach ◽  
David M. Pelz
Keyword(s):  
Cervical Spine ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Cervical Spine Injury ◽  
Cricoid Pressure ◽  
Macintosh Laryngoscope ◽  
Spine Injury ◽  
Neck Extension ◽  
Bullard Laryngoscope ◽  
Spine Movement

Background In the emergency trauma situation, in-line stabilization (ILS) of the cervical spine is used to reduce head and neck extension during laryngoscopy. The Bullard laryngoscope may result in less cervical spine movement than the Macintosh laryngoscope. The aim of this study was to compare cervical spine extension (measured radiographically) and time to intubation with the Bullard and Macintosh laryngoscopes during a simulated emergency with cervical spine precautions taken. Methods Twenty-nine patients requiring general anesthesia and endotracheal intubation were studied. Patients were placed on a rigid board and anesthesia was induced. Laryngoscopy was performed on four occasions: with the Bullard and Macintosh laryngoscopes both with and without manual ILS. Cricoid pressure was applied with ILS. To determine cervical spine extension, radiographs were exposed before and during laryngoscopy. Times to intubation and grade view of the larynx were also compared. Results Cervical spine extension (occiput-C5) was greatest with the Macintosh laryngoscope (25.9 degrees +/- 2.8 degrees). Extension was reduced when using the Macintosh laryngoscope with ILS (12.9 +/- 2.1 degrees) and the Bullard laryngoscope without stabilization (12.6 +/- 1.8 degrees; P < 0.05). Times to intubation were similar for the Macintosh laryngoscope with ILS (20.3 +/- 12.8 s) and for the Bullard without ILS (25.6 +/- 10.4 s). Manual ILS with the Bullard laryngoscope results in further reduction in cervical spine extension (5.6 +/- 1.5 degrees) but prolongs time to intubation (40.3 +/- 19.5 s; P < 0.05). Conclusions Cervical spine extension and time to intubation are similar for the Macintosh laryngoscope with ILS and the Bullard laryngoscope without ILS. However, time to intubation is significantly prolonged when the Bullard laryngoscope is used in a simulated emergency with cervical spine precautions taken. This suggests that the Bullard laryngoscope may be a useful adjunct to intubation of patients with potential cervical spine injury when time to intubation is not critical.

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