Aprahamian C, Thompson B M, Finger W A, Darin J C
Ann Emerg Med. 1984 Aug;13(8):584-7. doi: 10.1016/s0196-0644(84)80278-4.
We evaluated airway management maneuvers and the effects of cervical splinting on a model of an injured spinal column. X-ray films of a fresh cadaver verified a normal cervical spine. C5-C6 instability was created surgically and documented radiologically with flexion and extension maneuvers. Basic and advanced airway techniques were performed and were documented radiologically. The procedures were then repeated using different types of splinting. Chin lift, jaw thrust, esophageal obturator airway (EOA), and endotracheal intubation can cause extension, widening, and/or anterior subluxation. A two-piece, semirigid soft cervical collar may minimize flexion but not extension of the spine. With the Velcro in back, soft collars minimize flexion; with Velcro in front, they minimize extension. Standard nonsurgical airway management techniques appear to aggravate preexisting injuries. The soft collar and semirigid collar do little to prevent movement, and their presence may serve only as a warning to physicians that a neck injury may be present.
我们评估了气道管理操作以及颈椎固定对脊柱损伤模型的影响。新鲜尸体的X线片证实颈椎正常。通过手术造成C5 - C6节段不稳定，并通过屈伸操作进行放射学记录。实施了基础和高级气道技术，并进行放射学记录。然后使用不同类型的固定方法重复这些操作。抬颏、托颌、食管阻塞气道（EOA）和气管插管可导致脊柱伸展、增宽和/或前脱位。两件式半刚性软颈托可使脊柱屈曲最小化，但不能使伸展最小化。软颈托后面有魔术贴时可使屈曲最小化；前面有魔术贴时可使伸展最小化。标准的非手术气道管理技术似乎会加重已有的损伤。软颈托和半刚性颈托对防止脊柱移动作用不大，它们的存在可能仅对医生起到警示作用，提示可能存在颈部损伤。
