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3 results

  • Prehospital Spinal Immobilization: Effect of Effort on Kinematics of Voluntary Head-neck Motion Assessed using Accelerometry

  • Rob Pryce, Neil McDonald
  • Journal:
    Prehospital and Disaster Medicine / Volume 31 / Issue 1 / February 2016
    Published online by Cambridge University Press:
    17 December 2015, pp. 36-42
    Print publication:
    February 2016
  • Introduction

    Standards for immobilizing potentially spine-injured patients in the prehospital environment are evolving. Current guidelines call for more research into treatment practices. Available research into spinal immobilization (SI) reveals a number of limitations.

    Problem

    There are currently few techniques for measuring head and neck motion that address identified limitations and can be adapted to clinically relevant scenarios. This study investigates one possible method.

    Methods

    Study participants were fitted with miniaturized accelerometers to record head motion. Participants were exposed to three levels of restraint: none, cervical-collar only, and full immobilization. In each condition, participants were instructed to move in single planes, with multiple iterations at each of four levels of effort. Participants were also instructed to move continuously in multiple planes, with iterations at each of three levels of simulated patient movement. Peak and average displacement and acceleration were calculated for each immobilization condition and level of effort. Comparisons were made with video-based measurement. Participant characteristics also were tracked.

    Results

    Acceleration and displacement of the head increased with effort and decreased with more restraint. In some conditions, participants generated measurable acceleration with minimal displacement. Continuous, multi-dimensional motions produced greater displacement and acceleration than single-plane motions under similar conditions.

    Conclusion

    Study results suggest a number of findings: acceleration complements displacement as a measure of motion in potentially spine-injured patients; participant effort has an effect on outcome measures; and continuous, multi-dimensional motion can produce results that differ from single-plane motions. Miniaturized accelerometers are a promising technology for future research to investigate these findings in realistic, clinically relevant scenarios.

    PryceR , McDonaldN . Prehospital Spinal Immobilization: Effect of Effort on Kinematics of Voluntary Head-neck Motion Assessed using Accelerometry. Prehosp Disaster Med. 2016;31(1):36–42.

  • 29 - CT of the Spine

  • from PART III - COMPUTED TOMOGRAPHY
  • Edited by J. Christian Fox, University of California, Irvine
  • Book:
    Clinical Emergency Radiology
    Published online:
    07 December 2009
    Print publication:
    29 September 2008, pp 404-419

  • Summary

    Computed tomography (CT) of the spine is becoming one of the most common studies in the modern ED. CT is the fastest, cost-effective method of imaging the spine and provides the most accurate information for diagnosis, with the exception of some soft tissue or spinal cord lesions. CT is exactly as its name implies, a mathematical approximation of the multiple densities seen as the X-ray beam rotates around the patient. The pediatric population presents a wide array of pitfalls for the clinician when evaluating the spine. Dislocations and ligamentous injury are more common in the pediatric population; they can be occult on CT and require MRI. They also present with multiple levels of injury, and complete imaging of the spine is indicated if injury is found at any level of the spine. Correct clinical judgment is required prior to sending a patient to the scanner.