Swenson T M, Lauerman W C, Blanc R O, Donaldson W F, Fu F H
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
Am J Sports Med. 1997 Mar-Apr;25(2):226-30. doi: 10.1177/036354659702500216.
We investigated the effect of football helmet removal on the sagittal alignment of the cervical spine. A quantitative radiographic assessment of relative cervical spine position in subjects immobilized to a standard backboard wearing shoulder pads either with or without a helmet was performed. Comparison was made to a control situation with subjects on a backboard wearing no equipment. Ten subjects were studied using lateral computed tomographic scout films; each subject served as his own control. Radiographs were measured for overall sagittal cervical alignment and the amount of lordosis or kyphosis present within specific segments of the cervical spine. Mean values for each of the three defined situations (no equipment, shoulder pads and helmet, shoulder pads alone after helmet removal) were calculated and subjected to statistical analysis. No statistically significant difference in cervical sagittal alignment was noted when either no equipment or both shoulder pads and helmet were worn. In contrast, a statistically significant increase in cervical lordosis (extension) was found when comparing the control situation to that when only shoulder pads were worn after the helmet had been removed. The majority of this increase occurred in the subaxial spine. Therefore, the authors recommend that football players with a potential cervical spine injury be immobilized for transport with both their helmet and shoulder pads left in place, thereby maintaining the neck in a position most closely approximating "normal."
我们研究了摘除橄榄球头盔对颈椎矢状位排列的影响。对佩戴或不佩戴头盔及肩垫并固定在标准背板上的受试者的颈椎相对位置进行了定量影像学评估。将其与未佩戴任何装备、躺在背板上的受试者的对照情况进行比较。使用颈椎侧位计算机断层扫描定位片对10名受试者进行了研究；每名受试者均作为自身对照。对X线片进行测量，以评估颈椎矢状位的整体排列情况以及颈椎特定节段内前凸或后凸的程度。计算三种设定情况（未佩戴任何装备、佩戴肩垫和头盔、摘除头盔后仅佩戴肩垫）下各情况的平均值，并进行统计分析。当未佩戴任何装备或同时佩戴肩垫和头盔时，颈椎矢状位排列未发现有统计学意义的差异。相比之下，将对照情况与摘除头盔后仅佩戴肩垫的情况相比较时，发现颈椎前凸（伸展）有统计学意义的增加。这种增加大部分发生在颈椎下轴节段。因此，作者建议，对可能存在颈椎损伤的橄榄球运动员进行固定转运时，应保留其头盔和肩垫，从而使颈部保持在最接近“正常”的位置。
