| Spinal precautions | |
|---|---|
 A person with a hard cervical collar on a long board |
Spinal precautions, also known as spinal immobilization and spinal motion restriction, are efforts to prevent movement of the bones of the spine in those with a risk of a spine injury.[1] This is done as an effort to prevent injury to the spinal cord[1] in unstable spinal fractures.[2] About 0.5-3% of people with blunt trauma will have a spine injury,[3][4] with 42-50% of injuries due to motor vehicle accidents, 27-43% from falls or work injuries, and the rest due to sports injuries (9%) or assault (11%).[4][5][6] The majority of spinal cord injuries are to the cervical spine (neck, 52%), followed by the thoracic (upper back) and lumbar (lower back) spine.[4] Cervical spinal cord injuries can result in tetraplegia or paraplegia, depending on severity.[6] Of spine injuries, only 0.01%[7] are unstable and require intervention (either surgery or a spinal orthosis).[8]
Some authors argue that use of spinal precautions is controversial because benefit is unclear and there are significant drawbacks including pressure ulcers, increased pain, and delayed transport times.[9][7][10] Spinal boards can also be uncomfortable.[11]
- ^ a b Pollak, Andrew (1999). Refresher: Emergency Care and Transportation of the Sick and Injured. Jones & Bartlett Learning. p. 302. ISBN 9780763709129.
- ^ Vaccaro, A. R.; Silber, J. S. (2001-12-15). "Post-traumatic spinal deformity". Spine. 26 (24 Suppl): S111–118. doi:10.1097/00007632-200112151-00019. ISSN 0362-2436. PMID 11805617.
- ^ Ahn, Henry; Singh, Jeffrey; Nathens, Avery; MacDonald, Russell D.; Travers, Andrew; Tallon, John; Fehlings, Michael G.; Yee, Albert (August 2011). "Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines". Journal of Neurotrauma. 28 (8): 1341–1361. doi:10.1089/neu.2009.1168. ISSN 1557-9042. PMC 3143405. PMID 20175667.
- ^ a b c Connor, D.; Greaves, I.; Porter, K.; Bloch, M.; consensus group, Faculty of Pre-Hospital Care (December 2013). "Pre-hospital spinal immobilisation: an initial consensus statement". Emergency Medicine Journal. 30 (12): 1067–1069. doi:10.1136/emermed-2013-203207. ISSN 1472-0213. PMID 24232011.
- ^ Winn, Richard (January 21, 2022). Youmans & Winn Neurological Surgery (8th ed.). Elsevier. pp. 2415–2426. ISBN 978-0-323-67499-7.
- ^ a b Stein, Deborah M.; Knight, William A. (September 2017). "Emergency Neurological Life Support: Traumatic Spine Injury". Neurocritical Care. 27 (Suppl 1): 170–180. doi:10.1007/s12028-017-0462-z. ISSN 1556-0961. PMID 28913694.
- ^ a b White CC, 4th; Domeier, RM; Millin, MG; Standards and Clinical Practice Committee, National Association of EMS, Physicians (Apr–Jun 2014). "EMS spinal precautions and the use of the long backboard - resource document to the position statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma". Prehospital Emergency Care. 18 (2): 306–14. doi:10.3109/10903127.2014.884197. PMID 24559236. S2CID 207521864.
{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: numeric names: authors list (link) - ^ Cifu, David X. (2020). Braddom's Physical Medicine and Rehabilitation, Sixth Edition (6th ed.). Elsevier. pp. 248–260. ISBN 978-0-323-62539-5.
- ^ Velopulos, Catherine G.; Shihab, Hasan M.; Lottenberg, Lawrence; Feinman, Marcie; Raja, Ali; Salomone, Jeffrey; Haut, Elliott R. (May 2018). "Prehospital spine immobilization/spinal motion restriction in penetrating trauma: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST)". The Journal of Trauma and Acute Care Surgery. 84 (5): 736–744. doi:10.1097/TA.0000000000001764. ISSN 2163-0763. PMID 29283970.
- ^ Cite error: The named reference
Ot2015was invoked but never defined (see the help page). - ^ National Association of EMS Physicians; American College of Surgeons Committee on Trauma (2012). "EMS Spinal Precautions and the Use of the Long Backboard Position Statement of the National Association of EMS Physicians and the American College of Surgeons Committee on Trauma" (PDF). American College of Surgeons. Retrieved November 27, 2024.