Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA.
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New YorkUSA.
Prehosp Disaster Med. 2021 Dec;36(6):708-712. doi: 10.1017/S1049023X21001187. Epub 2021 Nov 3.
Over the past decade, Emergency Medical Service (EMS) systems decreased backboard use as they transition from spinal immobilization (SI) protocols to spinal motion restriction (SMR) protocols. Since this change, no study has examined its effect on the neurologic outcomes of patients with spine injuries.
The object of this study is to determine if a state-wide protocol change from an SI to an SMR protocol had an effect on the incidence of disabling spinal cord injuries.
This was a retrospective review of patients in a single Level I trauma center before and after a change in spinal injury protocols. A two-step review of the record was used to classify spinal cord injuries as disabling or not disabling. A binary logistic regression was used to determine the effects of protocol, gender, age, level of injury, and mechanism of injury (MOI) on the incidence of significant disability from a spinal cord injury.
A total of 549 patients in the SI period and 623 patients in the SMR period were included in the analysis. In the logistic regression, the change from an SI protocol to an SMR protocol did not demonstrate a significant effect on the incidence of disabling spinal injuries (OR: 0.78; 95% CI, 0.44 - 1.36).
This study did not demonstrate an increase in disabling spinal cord injuries after a shift from an SI protocol to an SMR protocol. This finding, in addition to existing literature, supports the introduction of SMR protocols and the decreased use of the backboard.
在过去的十年中，随着紧急医疗服务（EMS）系统从脊柱固定（SI）向脊柱运动限制（SMR）转变，背板的使用减少了。自这一变化以来，尚无研究探讨其对脊柱损伤患者神经结局的影响。
本研究旨在确定全州范围内从 SI 向 SMR 协议的转变是否对致残性脊髓损伤的发生率产生影响。
这是对一家一级创伤中心的患者在脊柱损伤协议改变前后的回顾性研究。通过两步记录审查，将脊髓损伤分类为致残性或非致残性。使用二项逻辑回归来确定协议、性别、年龄、损伤程度和损伤机制（MOI）对脊髓损伤导致显著残疾的发生率的影响。
共有 549 例患者在 SI 期，623 例患者在 SMR 期被纳入分析。在逻辑回归中，从 SI 协议转变为 SMR 协议对致残性脊柱损伤的发生率没有显著影响（OR：0.78；95%CI，0.44-1.36）。
本研究未发现从 SI 协议转变为 SMR 协议后致残性脊髓损伤的发生率增加。这一发现以及现有文献支持 SMR 协议的引入和背板使用的减少。
