Hu Calvin T, Dipaola Christian P, Conrad Bryan P, Horodyski Marybeth, Del Rossi Gianluca, Rechtine Glenn R
Department of Orthopaedics, University of Rochester Medical Center, New York, USA.
J Spinal Cord Med. 2013 Jan;36(1):58-65. doi: 10.1179/2045772312Y.0000000027.
Excessive spinal motion generated during multiple bed transfers of patients with unstable spine injuries may contribute to neurological deterioration.
To evaluate spinal motion in a cadaveric model of global spinal instability during hospital bed transfers using several commonly used techniques.
DESIGN/PARTICIPANTS: A motion analysis and evaluation of hospital bed transfer techniques in a cadaveric model of C5-C6 and T12-L2 global spinal instability. Setting/outcome measures: Global instability at C5-C6 and T12-L2 was created. The motion in three planes was measured in both the cervical and lumbar spine during each bed transfer via electromagnetic motion detection devices. Comparisons between transfers performed using an air-assisted lateral transfer device, manual transfer, a rolling board, and a sliding board were made based on the maximum range of motion observed.
Significantly less lateral bending at C5-C6 was observed in air-assisted device transfers when compared with the two other boards. Air-assisted device transfers produced significantly less axial rotation at T12-L2 than the rolling board, and manual transfers produced significantly less thoracolumbar rotation than both the rolling and sliding boards. No other significant differences were observed in cervical or lumbar motion. Motion versus time plots indicated that the log roll maneuvers performed during rolling board and sliding board transfers contributed most of the observed motion.
Each transfer technique produced substantial motion. Transfer techniques that do not include the logroll maneuver can significantly decrease some components of cervical and lumbar motion. Thus, some spinal motion can be reduced through selection of transfer technique.
脊柱损伤不稳定患者在多次病床转移过程中产生的脊柱过度活动可能导致神经功能恶化。
使用几种常用技术评估在医院病床转移期间全球脊柱不稳定尸体模型中的脊柱活动。
设计/参与者：对C5 - C6和T12 - L2全球脊柱不稳定尸体模型中的病床转移技术进行运动分析和评估。设置/结果测量：在C5 - C6和T12 - L2处造成全球不稳定。在每次病床转移期间，通过电磁运动检测装置测量颈椎和腰椎在三个平面内的活动。基于观察到的最大活动范围，对使用空气辅助横向转移装置、手动转移、滚动板和滑板进行的转移进行比较。
与其他两种板相比，在空气辅助装置转移中观察到C5 - C6处的侧弯明显减少。空气辅助装置转移在T12 - L2处产生的轴向旋转明显少于滚动板，手动转移产生的胸腰椎旋转明显少于滚动板和滑板。在颈椎或腰椎活动中未观察到其他显著差异。活动与时间图表明，在滚动板和滑板转移期间进行的翻身动作贡献了大部分观察到的活动。
每种转移技术都会产生大量活动。不包括翻身动作的转移技术可以显著减少颈椎和腰椎活动的某些组成部分。因此，通过选择转移技术可以减少一些脊柱活动。
