scholarly journals Comparison of the efficacy of three cervical collars in restricting cervical range of motion: A randomized study

2018 ◽  
Vol 27 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Jae Guk Kim ◽  
Sung Hwan Bang ◽  
Gu Hyun Kang ◽  
Yong Soo Jang ◽  
Wonhee Kim ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Cervical Spine Injury ◽  
Axial Rotation ◽  
The Other ◽  
Spine Injury ◽  
Cervical Range Of Motion ◽  
Flexion Extension ◽  
Cervical Immobilization ◽  
The Difference

Background: The cervical collar has been used as a common device for the initial stabilization of the cervical spine. Although many cervical collars are commercially available, there is no consensus on which offers the greatest protection, with studies showing considerable variations in their ability to restrict cervical range of motion. The use of the XCollar (Emegear, Carpinteria, CA) has been known to decrease the risk of spinal cord injury by minimizing potential cervical spinal distraction. We compared XCollar with two other cervical collars commonly used for adult patients with cervical spine injury to evaluate the difference in effectiveness between the three cervical collars to restrict cervical range of motion. Objectives: This study aimed to evaluate the difference between the three cervical collars in their ability to restrict cervical range of motion. Method: A total of 30 healthy university students aged 21–25 years participated in this study. Participants with any cervical disease and symptoms were excluded. Three cervical collars were tested: Philadelphia® Collar, Stifneck® Select™ Collar, and XCollar. A digital camera and an image-analysis technique were used to evaluate cervical range of motion during flexion, extension, bilateral bending and bilateral axial rotation. Cervical range of motion was evaluated in both the unbraced and braced condition. Results: XCollar permitted less than a mean of 10° of movement during flexion, extension, bilateral bending and bilateral axial rotation. This was less than the movement permitted by the other two cervical collars. Conclusion: XCollar presented superior cervical immobilization compared to the other two commonly used cervical collars in this study. Thus, when cervical collar is considered for an adult patient with cervical spine injury, XCollar might be one of the considerate options as a cervical immobilization device.

DETECTION OF PEDIATRIC CERVICAL SPINE INJURY

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 700-708 ◽  
Author(s):  
Hugh J.L. Garton ◽  
Matthew R. Hammer
Keyword(s):  
Cervical Spine ◽  
Young Children ◽  
Cervical Spine Injury ◽  
Diagnostic Yield ◽  
Plain Film ◽  
Spine Injury ◽  
Lower Sensitivity ◽  
X Rays ◽  
Flexion Extension ◽  
National Emergency

Abstract OBJECTIVE In evaluating the pediatric cervical spine for injury, the use of adult protocols without sufficient sensitivity to pediatric injury patterns may lead to excessive radiation doses. Data on injury location and means of detection can inform pediatric-specific guideline development. METHODS We retrospectively identified pediatric patients with codes from the International Classification of Diseases, 9th Revision, for cervical spine injury treated between 1980 and 2000. Collected data included physical findings, radiographic means of detection, and location of injury. Sensitivity of plain x-rays and diagnostic yield from additional radiographic studies were calculated. RESULTS Of 239 patients, 190 had true injuries and adequate medical records; of these, 187 had adequate radiology records. Patients without radiographic abnormality were excluded. In 34 children younger than 8 years, National Emergency X-Radiography Utilization Study criteria missed two injuries (sensitivity, 94%), with 76% of injuries occurring from occiput–C2. In 158 children older than 8 years, National Emergency X-Radiography Utilization Study criteria identified all injured patients (sensitivity, 100%), with 25% of injuries occurring from occiput–C2. For children younger than 8 years, plain-film sensitivity was 75% and combination plain-film/occiput–C3 computed tomographic scan had a sensitivity of 94%, whereas combination plain-film and flexion-extension views had 81% sensitivity. In patients older than 8 years, the sensitivities were 93%, 97%, and 94%, respectively. CONCLUSION Younger children tend to have more rostral (occiput–C2) injuries compared with older children. The National Emergency X-Radiography Utilization Study protocol may have lower sensitivity in young children than in adults. Limited computed tomography from occiput–C3 may increase diagnostic yield appreciably in young children compared with flexion-extension views. Further prospective studies, especially of young children, are needed to develop reliable pediatric protocols.

scholarly journals Examining the Range of Motion of the Cervical Spine: Utilising Different Bedside Instruments

2021 ◽  
Vol 28 (2) ◽  
pp. 100-105
Author(s):  
Aiman Asyraf Ahmad Sukari ◽  
Sarwinder Singh ◽  
Muhammad Hafiz Bohari ◽  
Zamzuri Idris ◽  
Abdul Rahman Izaini Ghani ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Clinical Examination ◽  
Lateral Flexion ◽  
Range Of Movement ◽  
Cervical Range Of Motion ◽  
Accuracy And Precision ◽  
Flexion Extension ◽  
Measuring Tape ◽  
Examination Techniques

Background: This paper outlines a summary of examination technique to identify the range of movement of the cervical spine. Due to common difficulties in obtaining tools for cervical examination within the district, a standardised compilation of easy-to-replicate examination techniques are provided using different tools. Methods: Bedside instruments that can be used includes a measuring tape, compass, goniometer, inclinometer and cervical range of motion (CROM) instrument. Discussion: Cervical flexion-extension, lateral flexion and rotation will be assessed with bedside instruments. This would aid in increasing accuracy and precision of objective measurement while conducting clinical examination to determine the cervical range of motion.

scholarly journals Evaluating the instability of injuries according to the AOSpine Subaxial Cervical Spine Injury Classification System

TRAUMA ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 34-44
Author(s):  
O.S. Nekhlopochyn ◽  
V.V. Verbov
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Classification System ◽  
Cervical Spine Injury ◽  
Sagittal Profile ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Flexion Extension ◽  
Injury Classification ◽  
Degree Of Instability

Background. The main criteria for determining surgery strategy in patients with traumatic subaxial cervical injury are as follows: the type and degree of damage to the osteo-ligamentous structures of cervical spine that determines the level of instability; the value of spinal cord compression; the state of the sagittal profile. The aim of this study was to assess the degree of instability in different types of cervical spine injuries according to AOSpine Subaxial Cervical Spine Injury Classification System. Materials and methods. We performed a retrospective analysis of Х-ray, computed tomography and magnetic resonance imaging data of 168 patients with traumatic injury of subaxial cervical spine. All of them were hospitalized at the Department of Spinal Cord Pathology of the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine 2008–2018. We assessed the degree of instability using the Cervical Spine Injury Severity Score and determined the type of damage according to the AOSpine Subaxial Cervical Spine Injury Classification System. Results. We found that the median rate of instability increases progressively with increasing severity of injury type. The widest range of instability values is observed in the compression damage: from 6 points (95% confidence interval (CI): 4.76–6.84) in A1 type to 11 points (95% CI: 9.48–11.81) in A4. For A2 and A3 types, we registered 7 (95% CI: 6.68–7.53) and 8 points (95% CI: 7.97–9.01), respectively. A smaller range of values characterizes flexion-extension injuries. The median progressively increases from B1 type — 13 points (95% CI: 12.4–13.92) to B3 type — 15.5 points (95% CI: 14.5–16.35). The value for B2 is intermediate and is 15 points (95% CI: 13.59–15.52). We registered maximum values in flexion-extension injuries — 18 points, for both B2 and B3 types. C type has the highest level of instability — 17 points (95% CI: 16.58–17.86) and a quite wide range of estimated values: from 13 to 20 points. Conclusions. The general trend is an increase in the level of instability in the range from A1 to C injury subtypes, but even A1 type in some cases are quite unstable and require surgery. In contrast to the classical views, type A injuries are often accompanied by da-mage to the facet joints, which must also be taken into account when determining the individual treatment.

Cervical End-Range Joint Motion Does Not Indicate Maximum Cervical Joint Motion In Healthy Adults. An Observational Study

2020 ◽  
Author(s):  
Victoria Blogg Andersen ◽  
Xu Wang ◽  
Mark De Zee ◽  
Lasse Riis Østergaard ◽  
Maciej Plocharski ◽  
...  
Keyword(s):  
Observational Study ◽  
Range Of Motion ◽  
Healthy Subjects ◽  
Joint Motion ◽  
Cervical Range Of Motion ◽  
Range Type ◽  
Flexion Extension ◽  
The Difference ◽  
Video Fluoroscopy ◽  
Average Contribution

Abstract BackgroundIn clinical diagnosis, the largest motion associated with cervical range of motion is thought to be found at end-range and it is this perception that forms the basis for the interpretation of flexion/extension studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified. PurposeTo provide a quantitative assessment of the difference between maximum motion and end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. Study designThis is an observational study. Subject sampleThirty three healthy subjects participated in the study. Outcome measuresMaximum motion, end-range motion and surplus motion in degrees were extracted from each cervical joint. MethodsThirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10 percent epochs between the initial upright position and the end-range position, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range. ResultsFor flexion 48.9% and for extension 47.2% of joints produced maximum motion before end-range (type Surplus). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at end-range (type Classic) and 5.2% of joints in flexion and 6.1% of joints in extension concluded their motion anti-directionally (type Anti-directional). Mann-Whitney U tests produced significant results for C2/C3, C3/C4 and C4/C5 in flexion and C1/C2, C3/C4 and C6/C7 in extension when comparing end- range motion for type Classic and type Surplus. The average contributions to cervical range-of-motion (ROM) (C0 to C7) for flexion and extension were 60.23֯ and 67.86֯ for type Classic and 42.22֯ and 49.05֯ for type Surplus respectively. Thus, the average contribution to cervical ROM was larger for type Classic than for type Surplus. The average pro-directional surplus motion was 2.41֯ ± 2.12֯ with a range of range (0.07֯ -14.23֯) for flexion and 2.02֯ ± 1.70֯ with a range of 0.04°-6.97° for extension.ConclusionThis is the first study to categorise joints by type of motion. Type Surplus constituted approximately half of the joints analysed in this study. Therefore, end-range motion cannot be assumed to be a demonstration of a joint´s maximum motion.

scholarly journals Role of Flexion—Extension Radiographs in Blunt Pediatric Cervical Spine Injury

2001 ◽  
Vol 8 (3) ◽  
pp. 237-245 ◽  
Author(s):  
Mark E. Ralston ◽  
Kee Chung ◽  
Patrick D. Barnes ◽  
John B. Emans ◽  
Sara A. Schutzman
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Flexion Extension

Range of Motion of the Upper Cervical Spine: flexion, extension, lateral bending, and axial rotation

2020 ◽  
Vol 8 ◽  
Author(s):  
Ana I. Lorente ◽  
César Hidalgo García ◽  
Jacobo Rodríguez Sanz ◽  
Mario Maza Frechín ◽  
Albert Pérez Bellmunt
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Axial Rotation ◽  
Upper Cervical Spine ◽  
Lateral Bending ◽  
Normal Range ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Upper Cervical ◽  
Life Threatening

Instability is a serious and life-threatening diagnosis in the upper cervical spine (occiput-atlas-axis), and a depth understanding of normal range of movement is required for clinical manual evaluation. To improve this knowledge, ten upper cervical spine specimens have been tested in flexion, extension, lateral bending, and axial rotation. 

scholarly journals Neck Braces and Driving Posture Affect Neck Mobility on Powered Two-Wheelers

2021 ◽  
Vol 33 (3) ◽  
pp. 337-345
Author(s):  
Brieg Lecoublet ◽  
Yvan Petit ◽  
Eric Wagnac ◽  
Dominic Boisclair ◽  
Pierre-Jean Arnoux
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Degrees Of Freedom ◽  
Traffic Accidents ◽  
Axial Rotation ◽  
Cervical Spine Injuries ◽  
Flexion Extension ◽  
Spine Injuries ◽  
Driving Posture ◽  
Neck Mobility

Cervical spine injuries are a major concern for motorcyclists in traffic accidents and racing competitions. Neck braces aim to prevent cervical spine injuries during accidents by reducing the neck range of motion, and keeping it under physiological limits. This work aims to evaluate the ability of neck braces to reduce neck mobility for two driving postures associated with PTW configurations. The neck mobility of twelve volunteer subjects testing four neck braces on two powered two-wheelers (scooter and racing motorbike) is measured using an optoelectronic motion capture system. With the tested neck braces worn, neck mobility is significantly reduced as compared to the physiological range of motion in all degrees of freedom. However, only flexion/extension is reduced by all neck braces tested. This suggests that these brace designs do not provide protection against all the cervical spine loading directions that may occur in a trauma. Furthermore, specific type of each powered two-wheeler considered significantly affects the neck mobility in axial rotation, as well as the postero-anterior and caudo-cranial translations, thus underscoring the need to consider the driving posture when evaluating neck brace devices.

Stress Changes in Intervertebral Discs of the Cervical Spine After Partial Fusion

2003 ◽  
Author(s):  
Abraham Tchako ◽  
Ali M. Sadegh
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Intervertebral Discs ◽  
Fe Model ◽  
Loading Mode ◽  
Flexion Extension ◽  
Stress Changes ◽  
Partial Fusion ◽  
The Difference ◽  
Disc Level

A detailed and validated 3D FE model of human cervical spine (Sadegh et al. 2000) was altered to simulate partial fusion. Five single level partially fused new models, one at each disc level, were used to study the change in stresses in adjacent levels. Two cases of partial fusion, 80% and 60% were considered. The fused models were loaded with a 50 N compressive pre-load and with a 1.5 Nm moment in flexion, extension, lateral bending and axial rotation. The previously obtained results of the unfused model (Tchako et al. 2002) and of the fused models were used to study the change in stresses in adjacent levels. The results indicate that, in general, there are stress changes as high as 94%, depending on the loading mode and location, in adjacent discs after discectomy and fusion. However, the difference between the stress change of 80% and 60% of partial fusion is insignificant.

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