Prinsen R K, Syrotuik D G, Reid D C
Department of Athletics, University of Alberta, Edmonton, Canada.
Clin J Sport Med. 1995 Jul;5(3):155-61. doi: 10.1097/00042752-199507000-00004.
There is lack of consensus among prehospital personnel (athletic therapists, paramedics, sport physiotherapists) concerning specific aspects of initial care and assessment of injured athletes presenting signs and symptoms of a cervical spine injury (CSI). In instances of serious injury involving the head and/or spine, complicated by altered levels of consciousness, protective equipment such as helmets and shoulder pads may provide a hinderance to prompt, safe and efficient management. Specifically, there is disagreement concerning the need or advisability of removing protective head gear, as in the case of football and hockey athletes. Using the technique of fluoroscopy, the cervical spine displacement of 21 male football and hockey athletes was determined while wearing protective shoulder pads and protective head equipment at the following times (a) during helmet removal, (b) during cervical collar application, and (c) as the helmetless head was allowed to rest. Subsequent frame-by-frame video arthokinematic analysis, using computer-assisted digitization, showed significant alterations in the position of adjacent cervical vertebrae during helmet removal, cervical collar application, and head rest. Results suggest that stabilization and transportation of football and hockey athletes with suspected CSI in their respective protective equipment is recommended in order to reduce the risk of further trauma by unnecessary cervical spine motion.
对于出现颈椎损伤（CSI）体征和症状的受伤运动员，院前急救人员（运动治疗师、护理人员、运动物理治疗师）在初始护理和评估的具体方面缺乏共识。在涉及头部和/或脊柱的严重损伤且伴有意识水平改变的情况下，头盔和肩垫等防护装备可能会妨碍及时、安全和有效的处理。具体而言，对于是否需要或是否适合摘除防护头盔，比如在足球和曲棍球运动员的情况中，存在分歧。利用荧光透视技术，测定了21名男性足球和曲棍球运动员在佩戴防护肩垫和防护头部装备的情况下，在以下时段的颈椎移位情况：(a)摘除头盔期间；(b)佩戴颈托期间；(c)摘除头盔后头部静止时。随后，通过计算机辅助数字化进行逐帧视频关节运动学分析，结果显示在摘除头盔、佩戴颈托和头部静止过程中，相邻颈椎的位置发生了显著变化。结果表明，建议对疑似颈椎损伤的足球和曲棍球运动员在其各自的防护装备内进行固定和转运，以降低因不必要的颈椎活动而导致进一步创伤的风险。
