EMERGENCY CERVICAL-SPINE IMMOBILIZATION

Study objective: To determine the effectiveness of a cervical-spine immobilization using a rigid cervical extrication collar and an Ammerman halo orthosis with and without spine boards. Design: A mixed model multivariate design with one within factor (device type) and one between factor (spine board application). Setting: Radiology suite. Type of participants: Twenty normal men with a mean age of 29.6. Interventions: Unrestrained cervical motion was compared with motion in a cervical extrication collar and an Ammerman halo orthosis with and without a spine board. Measurements: Photographic measurement of head and neck motion during maximal flexion-extension, lateral bending, and rotation. Radiologic measurement of maximal intervertebral flexion-extension. Main results: Both cervical extrication collar and Ammerman halo orthosis significantly reduced motion in all planes (P<.001) with the Ammerman halo orthosis reducing these motions significantly more (P<.001). With the use of a spine board these motions were restricted even more (P<.001). The Ammerman halo orthosis with a spine board provided the greatest immobilization, equivalent to that provided by an halo-vest. Conclusion: A rigid cervical collar and a spine board provide significantly better immobilization than the collar alone. Further immobilization is provided by an Ammerman halo orthosis.