OBJECTIVES
To determine whether a novel immobilization collar called the Nebraska collar would restrict motion of the cervical spine better than three traditional designs: the Philadelphia collar, the sterno occipital mandibular immobilizer (S.O.M.I.), and the Lehrman-Minerva cervical orthosis.
DESIGN
Cervical spine radiographs and a compass were used to assess motion allowed by four separate cervical collars placed on volunteers.
SETTING
University-affiliated level one trauma center.
PATIENTS/PARTICIPANTS
Fourteen paid volunteers (six females and eight males) between the ages of twenty and thirty-five years (mean twenty-five years) were recruited.
MAIN OUTCOME MEASUREMENTS
The maximum amount of flexion, extension, and lateral bending permitted by each collar was assessed by cervical radiographs taken of the volunteers while wearing each of the four collars. Maximum rotation was measured with a compass positioned on the top of the head of the volunteers and oriented in the horizontal plane.
RESULTS
The Nebraska collar restricted rotation (p < 0.0001) and lateral bending (p < 0.0001) significantly more than did the other three orthoses. In total maximum extension from occiput to C7, the Nebraska collar was found to be more restrictive than the Philadelphia collar (p < 0.05) and the S.O.M.I. (p < 0.05). In total maximum flexion, there was no statistically significant difference among the four collars. When the total maximum flexion-to-extension motion was measured, both the Nebraska and Lehrman-Minerva cervical collars were found to be more restrictive than the Philadelphia collar (p < 0.05).
CONCLUSION
The new Nebraska collar provides stabilization that is significantly more rigid than the other models tested, with no difference in patient comfort.
[1]
B. Rumack,et al.
Clinical toxicology of cyanide: North American clinical experiences
,
1986
.
[2]
R. Waters,et al.
Emergency cervical-spine immobilization.
,
1992,
Annals of emergency medicine.
[3]
R M Johnson,et al.
Cervical orthoses: a guide to their selection and use.
,
1981,
Clinical orthopaedics and related research.
[4]
W. Southwick,et al.
Cervical orthoses. A study comparing their effectiveness in restricting cervical motion in normal subjects.
,
1977,
The Journal of bone and joint surgery. American volume.
[5]
E. Bigsby,et al.
A comparison of methods of cervical immobilization used in patient extrication and transport.
,
1985,
The Journal of trauma.
[6]
G. Winzelberg,et al.
Clinical and radiological evaluation of Vertebrace extrication collars.
,
1990,
The Journal of emergency medicine.
[7]
N. Mcswain,et al.
Comparison of two new immobilization collars.
,
1992,
Annals of emergency medicine.
[8]
L. Baer,et al.
A radiographic comparison of prehospital cervical immobilization methods.
,
1987,
Annals of emergency medicine.