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Updated: Sep 10, 2025
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Association Between Collar Type and Incidence of Cervical Spinal Cord Injury in Trauma Patients
Matthew R Shaw1, Joseph Liu2, Nicholas Segel2
1Northern Arizona Healthcare, Flagstaff, AZ.
Objective:
Debate exists on how to best immobilize the cervical spine in the prehospital setting. Rigid cervical collars have been considered the standard of care for both the prevention and care of patients with suspected cervical spinal cord injury (c-SCI). Recently, soft c-collars have begun replacing rigid collars as they are better tolerated by patients. The aim of this study was to compare the safety of these 2 devices by evaluating the prevalence of c-SCI in patients immobilized with a rigid c-collar with those in a soft c-collar.
Methods:
A retrospective review of data collected for the purpose of quality improvement was conducted. All cases with possible c-SCI were included. Cases with missing hospital International Classification of Disease code or documentation of emergency medical service neurologic examination were excluded. The primary outcome was c-SCI diagnosis at hospital discharge. A secondary outcome was the prevalence of c-SCI among those at high risk for c-SCI. Descriptive and chi-square analyses were completed to compare the cohorts.
Results:
Of 882 patients with possible c-SCI, 267 were placed in a rigid collar and 615 in soft collars. Respectively, of those in the rigid and soft collar groups, the median age was 36 (interquartile range 24.5-53) years and 39 (interquartile range 24-58) years, and 54% (134) versus 64% (313) were male. Incidence of c-SCI was 0.8% in the rigid c-collar versus 1.5% in the soft collar group (P = .460). Among those cases with neurologic deficit noted by emergency medical services, there was no difference in incidence of c-SCI in the rigid (2/29, 6.9%) versus the soft (5/87, 5.7%) collar groups (P = .833).
Conclusion:
In this limited retrospective review, no statistically significant difference in the rates of c-SCI was observed between patients who were immobilized using a rigid versus soft c-collar. Additional investigation is needed to determine whether rigid and soft c-collars provide equal protection.
