O'Quinn Payton C, Smith Lou M
Department of Surgery, East Tennessee State University Quillen College of Medicine, Johnson City, USA.
Department of Surgery, University of Tennessee Medical Center, Knoxville, USA.
Cureus. 2025 May 13;17(5):e84054. doi: 10.7759/cureus.84054. eCollection 2025 May.
Removing a cervical collar (C-collar) in trauma patients is a clinically complex and often controversial subject; existing guidelines have some areas of ambiguity. Little to no literature exists regarding C-collar removal in patients with chronic degenerative changes of the cervical spine or dementia. We present two trauma patients who were initially cleared of their C-collars after undergoing a cervical spine CT scan. Both patients later required their C-collars to be replaced and required neurosurgical consultation; one patient developed neurological deficits. Both patients were mentally altered in some form; one via intoxication and the other via existing dementia. Additionally, both patients had chronic degenerative cervical spine changes. While adverse outcomes following C-collar removal are rarely recorded in the literature, this is likely due to underreporting. In the absence of literature specific to chronic degenerative changes or dementia, we recommend that clinicians exercise increased caution when removing C-collars in this patient population.
在创伤患者中移除颈托是一个临床复杂且常具争议的话题；现有指南在某些方面存在模糊之处。关于颈椎慢性退行性变或痴呆患者移除颈托的文献几乎没有。我们介绍两名创伤患者，他们在接受颈椎CT扫描后最初被移除了颈托。两名患者后来都需要重新戴上颈托并需要神经外科会诊；其中一名患者出现了神经功能缺损。两名患者都有某种形式的精神状态改变；一名是因中毒，另一名是因现有的痴呆症。此外，两名患者都有颈椎慢性退行性变。虽然文献中很少记录移除颈托后的不良后果，但这可能是由于报告不足。在缺乏针对慢性退行性变或痴呆症的具体文献的情况下，我们建议临床医生在为这类患者移除颈托时要格外谨慎。
