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The Relevance of the Occult Cervical Spine Controversy and Mechanism of Injury to Prehospital Protocols: A Review of the Issues and Literature

Published online by Cambridge University Press:  28 June 2012

Alexander M. Butman ,
Daniel T. Schelble  and
Richard W. Vomacka
Alexander M. Butman*
Affiliation:
Emergency Training Institute, Fairlawn, Ohio and the Department of Emergency Medicine, Akron General Medical Center, Akron, Ohio
Daniel T. Schelble
Affiliation:
Chair, Department of Emergency Medicine, Akron General Medical Center, Akron, Ohio
Richard W. Vomacka
Affiliation:
Department of Medical Technology, Cuyahoga Community College, Cleveland, Ohio
*
Executive Director, Emergency Training Institute, Miller Landing, Building 200, 150 North Miller Road, Akron, OH 44333, USA
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Extract

Prehospital guidelines that define the clinical indications for spine trauma also serve as the criteria for selective spinal immobilization in the field. Therefore, these criteria are important for avoiding further spinal cord damage. Because some spine injuries may occur without neurological deficits or other clinical signs, the recommended field guidelines extend beyond the signs and symptoms and include mechanisms of injury or other injuries commonly associated with a high risk of spine injury.

Keywords

cervical spinecontroversycurriculafracturesimmobilizationmechanism of injuryoccult cervical spinal injuryprehospitalspinal cordspinal injury
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 11 , Issue 3 , September 1996 , pp. 228 - 233
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1996

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References

1. Butman, AB, Martin, SW, Vomacka, RW, et al. : A Comprehensive Guide To Pre-Hospital Skills. Emergency Training, Akron, Ohio 1995: p 630.Google Scholar
2. McSwain, NE Jr, (ed): Pre-Hospital Trauma Life Support Text (PHTLS); Mosby Lifeline, St. Louis, MO, 1994.Google Scholar
3. Campbell, JE: Basic Trauma Life Support Text (BTLS); A Brady Book, Englewood Cliffs, NJ; 1994.Google Scholar
4. US Department of Transportation: EMT-B National Standard Curriculum, The National Highway Traffic Safety Administration (NHTSA); Washington, DC, 1994.Google Scholar
5. Hills, MW, and Deane, SA: Head injury and facial injury: Is there an increased risk of cervical spine injury? J of Trauma 1993;3:549–554.CrossRefGoogle Scholar
6. Ringenberg, BJ, Fisher, AK, Urdanta, LF, et al. : Rational ordering of cervical spine radiographs following trauma. Ann Emerg Med 1988:17:792–796.CrossRefGoogle ScholarPubMed
7. Reid, DC, Henderson, R, Saboe, L, et al. : Etiology and clinical course of missed spine fractures. J Trauma 1987;27:980–986.CrossRefGoogle ScholarPubMed
8. Meyer, PR, (ed): Annual Progress Report of the Midwest Regional Spinal Cord Injury Care System; Northwestern University McGaw Medical Center, Northwestern Memorial Hospital, Rehabilitation Institute of Chicago; 1988.Google Scholar
9. Chan, D, Goldberg, R, Tascone, , et al. : The effect of spinal immobilization on healthy volunteers. Ann Emerg Med 1994;23:48–51.CrossRefGoogle ScholarPubMed
10. Barney, RN, Cordwell, WH, and Miller, E: Pain associated with immobilization on rigid spine boards. Ann Emerg Med 1989;18:918. Abstract.Google Scholar
11. Bauer, D, Kowalski, R: Effects of spinal immobilization devices on pulmonary function in healthy non-smoking man. Ann Emerg Med 1988;17:915–918.CrossRefGoogle Scholar
12. Schafermeyer, RW, Ribbeck, BM, Gaskins, J, et al. : Respiratory effects of spinal immobilization in children. Ann Emerg Med 1991;20:1017–1019.CrossRefGoogle ScholarPubMed
13. Op cit: Comprehensive Guide To Pre-Hospital Skills; pp 637–734.Google Scholar
14. Herzenberg, JE, Hensinger, RN, Dedrick, DK, et al. : Emergency transport and positioning of young children who have an injury of the cervical spine. J Bone & Joint Surg 1989;17:15–22.CrossRefGoogle Scholar
15. Nypaver, M, Treloar, D: Neutral cervical spine positioning in children. Ann Emerg Med 1994;23:208–211.CrossRefGoogle ScholarPubMed
16. Fischer, RP: Cervical radiographic evaluation of alert patients following blunt trauma. Ann Emerg Med 1984;13:905–907.CrossRefGoogle ScholarPubMed
17. Buchulis, BL, Long, WB, Hynes, GD, et al. : Clinical indications for cervical spine radiographs in the traumatized patient. Ann J Surg 1987;153:473–478.CrossRefGoogle Scholar
18. Sadison, D, Vaneck, VW, Racanelli, JL, et al. : Clinical indications for cervical spine radiographs in alert trauma patients. Amer Surgeon, 1991;57:366–369.Google Scholar
19. Hoffman, JR, Schriger, DL, Mower, W, et al. : Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med 1992;21:50–56.CrossRefGoogle ScholarPubMed
20. Roberge, RJ: Letter To The Editor: Ann Emerg Med 1993;22:148 Letter.Google Scholar
21. Walter, J, Doris, PE, Shaffer, MA: Clinical presentation of patients with acute cervical spine injury. Ann Emerg Med 1984;13:512–515.CrossRefGoogle ScholarPubMed
22. Jacobs, LM, Schwartz, R: Prospective analysis of acute cervical spine inury: A methodology to predict injury. Ann Emerg Med, 1986;15:44–49.CrossRefGoogle Scholar
23. Ross, SE, Schwab, CW, David, ET, et al. : Clearing the cervical spine: Initial radiologic evaluation. J Trauma 1987;27:1055–1060.CrossRefGoogle ScholarPubMed
24. Laham, JL, Cotcamp, DH, Gibbons, PA, et al. : Isolated head injuries versus multiple trauma in pediatric patients: do the same indicators for cervical spine evaluation apply? Ped Neuro Surg 1994;21:221 Abstract.CrossRefGoogle ScholarPubMed
25. McKee, TR, Tinkoff, G, Rhodes, M, et al. : Asymptomatic occult cervical spine fracture: case report and review of the literature. J Trauma 1990;30:623–626.CrossRefGoogle ScholarPubMed
26. Pal, JM, Mulder, DS, Brown, RA, et al. : Assessing multiple trauma: Is the cervical spine enough? J Trauma 1988;28:1282–1284.CrossRefGoogle Scholar
27. Keenan, TL, Antony, BS, Benson, DR: Non-contiguous spinal fractures. J Trauma 1990;30:489–491.CrossRefGoogle Scholar
28. Frankel, HL, Rozycki, GS, Ochsner, MG, et al. : Indications for obtaining surveillance thoracic and lumbar spine radiographs. J Trauma 1994;37:673–676.CrossRefGoogle ScholarPubMed
29. Davis, JW, Phreaner, DL, Hoyt, DB, et al. : The etiology of missed cervical spine injuries. J Trauma 1993;34:342–346.CrossRefGoogle ScholarPubMed
30. Gerrelts, BD, Peterson, EU, Mabry, J, et al. : Delayed diagnosis of cervical spine injuries. J Trauma 1991;31:1622–1626.CrossRefGoogle ScholarPubMed
31. Cohn, SM, Lyle, WG, Linden, CH, et al. : Exclusion of cervical spine injury: A prospective study. J Trauma, 1991;31:570.CrossRefGoogle ScholarPubMed
32. Goth, P: Spine injury: clinical criteria for assessment and management; (approved by the Maine EMS Physician Advisory Board and the State of Maine EMS Office), Medical Care Development Inc., Augusta, Maine; May 1994.Google Scholar