Related Experiment Videos
Angulation of the pediatric cervical spine with and without cervical collar
1Department of Pediatrics, University of Michigan, Ann Arbor, USA.
Insights
Semirigid cervical collars do not prevent cervical spine (CS) flexion in young children immobilized on back boards. Current immobilization methods are insufficient for optimal CS positioning in pediatric patients.
Area of Science:
- Pediatric Emergency Medicine
- Orthopedic Surgery
- Radiology
Background:
- Cervical spine (CS) immobilization is crucial in pediatric trauma.
- Back boards and cervical collars are commonly used for prehospital CS stabilization.
- The effectiveness of these devices in preventing CS flexion in young children is not well-established.
Purpose of the Study:
- To evaluate the efficacy of semirigid cervical collars in eliminating cervical spine flexion in children under 8 years old.
- To assess the degree of CS flexion in pediatric patients immobilized on back boards with and without cervical collars.
Main Methods:
- Prospective clinical study conducted in a pediatric emergency department.
- Eighteen head-injured children under 8 years old underwent cervical spine radiography.
- Lateral Cobb angles (C2-C6) were measured with and without a semirigid cervical collar while patients were on back boards.
Main Results:
- Mean cervical spine flexion was 3.4 ± 9.9 degrees with a collar and 5.6 ± 6.8 degrees without a collar.
- The difference in flexion between the two conditions was not statistically significant (P > 0.05).
- A significant degree of cervical spine flexion persisted in most children despite collar application.
Conclusions:
- Semirigid cervical collars do not effectively eliminate cervical spine flexion in young children immobilized on back boards.
- Current equipment is inadequate for optimal cervical spine immobilization in this population.
- Further research is required to develop and validate improved methods for pediatric CS immobilization.
Study Objective:
To determine whether semirigid cervical collars eliminate cervical spine (CS) flexion in children on back boards.
Design:
Prospective clinical study.
Setting:
An urban pediatric emergency department.
Participants:
Eighteen head-injured children < 8 years of age undergoing CS radiographs.
Interventions:
Children were secured to back boards, and semirigid cervical collars were applied. Following CS clearance, the collar was removed, and an additional lateral film without collar was obtained. C2-C6 lateral Cobb angles were measured on both lateral films.
Main Results:
Mean flexion with collar was 3.4 +/- 9.9 degrees and 5.6 +/- 6.8 degrees without a collar P > 0.05
Conclusion:
Most children < 8 years, when immobilized on back boards have flexed CSs. Semirigid cervical collars do not eliminate flexion. Further study is needed to develop and test different methods of CS immobilization as present equipment is unable to position the CS optimally.