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受控实验室对比研究:颈椎不稳定患者使用足球装备时的运动情况——三种脊柱板搬运技术。

Controlled Laboratory Comparison Study of Motion With Football Equipment in a Destabilized Cervical Spine: Three Spine-Board Transfer Techniques.

机构信息

Department of Orthopaedics, University of Texas, Houston, Texas, USA.

Department of Orthopaedics, University of Florida, Gainesville, Florida, USA.

出版信息

Orthop J Sports Med. 2015 Sep 8;3(9):2325967115601853. doi: 10.1177/2325967115601853. eCollection 2015 Sep.

Abstract

BACKGROUND

Numerous studies have shown that there are better alternatives to log rolling patients with unstable spinal injuries, although this method is still commonly used for placing patients onto a spine board. No previous studies have examined transfer maneuvers involving an injured football player with equipment in place onto a spine board.

PURPOSE

To test 3 different transfer maneuvers of an injured football player onto a spine board to determine which method most effectively minimizes spinal motion in an injured cervical spine model.

STUDY DESIGN

Controlled laboratory study.

METHODS

Five whole, lightly embalmed cadavers were fitted with shoulder pads and helmets and tested both before and after global instability was surgically created at C5-C6. An electromagnetic motion analysis device was used to assess the amount of angular and linear motion with sensors placed above and below the injured segment during transfer. Spine-boarding techniques evaluated were the log roll, the lift and slide, and the 8-person lift.

RESULTS

The 8-person lift technique resulted in the least amount of angular and linear motion for all planes tested as compared with the lift-and-slide and log-roll techniques. This reached statistical significance for lateral bending (P = .031) and medial-lateral translation (P = .030) when compared with the log-roll maneuver. The lift-and-slide technique was significantly more effective at reducing motion than the log roll for axial rotation (P = .029) and lateral bending (P = .006).

CONCLUSION

The log roll resulted in the most motion at an unstable cervical injury as compared with the other 2 spine-boarding techniques examined. The 8-person lift and lift-and-slide techniques may both be more effective than the log roll at reducing unwanted cervical spine motion when spine boarding an injured football player. Reduction of such motion is critical in the prevention of iatrogenic injury.

摘要

背景

大量研究表明,对于不稳定脊柱损伤的患者,有许多优于滚动患者的替代方法,尽管这种方法仍常用于将患者放置在脊柱板上。以前没有研究过涉及带有装备的受伤足球运动员转移到脊柱板上的转移动作。

目的

测试将受伤的足球运动员转移到脊柱板上的 3 种不同转移动作,以确定哪种方法最有效地最小化受伤颈椎模型中的脊柱运动。

研究设计

对照实验室研究。

方法

将 5 个完整的、轻度防腐的尸体进行肩部和头盔的适配,并在 C5-C6 处进行手术创建整体不稳定之前和之后进行测试。使用电磁运动分析设备,通过在受伤节段上方和下方放置传感器,来评估在转移过程中角运动和线性运动的量。评估的脊柱板固定技术包括滚动法、提升和滑动法以及 8 人提升法。

结果

与提升和滑动法和滚动法相比,8 人提升法在所有测试平面上导致的角运动和线性运动最小。与滚动法相比,这在横向弯曲(P =.031)和侧向平移(P =.030)方面达到统计学意义。与滚动法相比,提升和滑动法在轴向旋转(P =.029)和横向弯曲(P =.006)方面更有效地减少运动。

结论

与其他 2 种脊柱板固定技术相比,滚动法在不稳定的颈椎损伤中会导致最大的运动。在对受伤的足球运动员进行脊柱板固定时,8 人提升法和提升和滑动法可能比滚动法更有效地减少不必要的颈椎运动。减少这种运动对于预防医源性损伤至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9e4/4622296/65f428b49a7b/10.1177_2325967115601853-fig1.jpg

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