Conrad Bryan P, Rechtine Glenn, Weight Mark, Clarke Joanne, Horodyski Marybeth
Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida 32611, USA.
J Trauma. 2010 Aug;69(2):432-6. doi: 10.1097/TA.0b013e3181e89f58.
Hospital bed transfers, moves to examination room, X-ray, hospital bed, and/or surgery, have the potential of causing harm to a patient with an unstable cervical spine. This study evaluated motion generated in an unstable segment of the cervical spine during hospital bed transfers. A secondary goal purpose was to assess reduction in cervical motion using three collars and a no collar condition.
Cervical spine instability was created at C5-C6 in cadavers. A repeated measures design was used to compare bed transfer techniques: manual transfer performed by six trained individuals and a transfer made by two people using the On3 lateral transfer device. Both techniques were tested under four collar conditions. Cervical spine motion was measured using an electromagnetic motion analysis device with sensors fixed to the anterior bodies of C5 and C6.
No significant differences were observed between transfer techniques (flexion, [p = 0.325]; axial rotation [p = 0.590]; lateral bending [p = 0.112]). Nor were there significant differences among the three collars used (flexion [p = 0.462]; axial rotation [p = 0.434]; lateral bending [p = 0.250]). For all transfers, using no collar resulted in more motion than using a collar; but was not statistically significant.
Bed transfers made with a lateral transfer device seem to be as safe as those made by the lift and slide manual transfer. None of the collars tested were significantly better at preventing cervical spine motion during a transfer, but each allowed less movement than no collar.
将患者从病床转运至检查室、X光室、返回病床以及/或者进行手术，都有可能对颈椎不稳定的患者造成伤害。本研究评估了在病床转运过程中颈椎不稳定节段产生的运动。第二个目标是评估使用三种颈托以及不使用颈托的情况下颈椎运动的减少情况。
在尸体的C5-C6节段造成颈椎不稳定。采用重复测量设计来比较病床转运技术：由六名经过训练的人员进行手动转运，以及由两人使用On3横向转运设备进行转运。两种技术均在四种颈托条件下进行测试。使用电磁运动分析设备测量颈椎运动，传感器固定在C5和C6椎体前方。
在转运技术之间未观察到显著差异（前屈，[p = 0.325]；轴向旋转[p = 0.590]；侧弯[p = 0.112]）。所使用的三种颈托之间也没有显著差异（前屈[p = 0.462]；轴向旋转[p = 0.434]；侧弯[p = 0.250]）。对于所有转运，不使用颈托比使用颈托产生的运动更多；但差异无统计学意义。
使用横向转运设备进行病床转运似乎与抬移和滑动手动转运一样安全。在测试的颈托中，没有一种在转运过程中预防颈椎运动方面明显更好，但每种颈托都比不使用颈托时允许的运动更少。
