Spinal immobilization on a flat backboard: does it result in neutral position of the cervical spine?

STUDY OBJECTIVES

To determine the amount of occipital padding required to achieve neutral position of the cervical spine when a patient is immobilized on a flat backboard. Neutral position was defined as the normal anatomic position of the head and torso that one assumes when standing looking straight ahead.

DESIGN

Descriptive with hypothesis testing of selected descriptive elements.

SETTING

University campus and hospital.

SUBJECTS

One hundred healthy young adults with no history of back disease.

INTERVENTIONS

Volunteers were measured in standing and supine positions.

MEASUREMENTS

Occipital offset; height; weight; and head, neck, and chest circumferences were measured for each subject.

MAIN RESULTS

The amount of occipital offset required to achieve neutral position varied from 0 to 3.75 in. (mean, 1.5 in.). Mean occipital offset for men (1.67 in.) was significantly greater than that for women (1.31 in.) Easily obtained body measurements did not accurately predict occipital offset.

CONCLUSION

Immobilization on a flat backboard would place 98% of our study subjects in relative cervical extension. Occipital padding would place a greater percentage of patients in neutral position and increase patient comfort during transport.