ArticlePloS one2018
Motion and dural sac compression in the upper cervical spine during the application of a cervical collar in case of unstable craniocervical junction-A study in two new cadaveric trauma models.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Evidence for the use of spinal collars in stabilising spinal injuries in the pre-hospital setting in trauma patients: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Effect of prehospital cervical spine immobilization on mortality and neurological outcome in trauma patients: an observational cohort study with propensity score matching based on the trauma registry of the German trauma society (TraumaRegister DGU®).World journal of emergency surgery : WJES · 2026Observational
- Spinal Motion Restriction for Possible Traumatic Cervical Spine Injury: A Scoping Review.Cureus · 2025Review
- Analysis of spine motion during prehospital extrication procedures in motorsport.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Epidemiology and predictors of traumatic spine injury in severely injured patients: implications for emergency procedures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Development and first application testing of a new protocol for CT-based stability evaluation of the injured upper cervical spine.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- A multicenter cohort study on the association between prehospital immobilization and functional outcome of patients following spinal injury in Asia.Scientific reports · 2022Article
- An Innovative Prone Position Using a Body-Shape Plaster Bed and Skull Traction for Posterior Cervical Spine Fracture Surgeries.Frontiers in surgery · 2022Article
- [The position of the head during treatment in the emergency room-an explorative analysis of immobilization of the cervical spine].Der Anaesthesist · 2021Article
- Analysis of remaining motion using one innovative upper airway opening cervical collar and two traditional cervical collars.Scientific reports · 2021Article
- Biomechanical Effects of Lateral Inclination COrthopaedic surgery · 2021Article
- Analysis of cervical spine immobilization during patient transport in emergency medical services.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Article
- Cervical Spine Immobilization in Patients With a Geriatric Facial Structure: The Influence of a Geriatric Mandible Structure on the Immobilization Quality Using a Cervical Collar.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- The Influence of Cervical Spine Angulation on Symptoms Associated With Wearing a Rigid Neck Collar.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- [Development and first application testing of a new protocol for preclinical spinal immobilization in children : Assessment of indications based on the E.M.S. IMMO Protocol Pediatric].Der Unfallchirurg · 2020Article
- Success Rate of Endotracheal Intubation Using Inline Stabilization with and without Cervical Hard Collar; a Comparative Study.Archives of academic emergency medicine · 2020Article
- [Conventional intubation and laryngeal tube in cervical spine instability : Changes in the width of the dural sac in unfixed human body donors].Der Anaesthesist · 2019Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnstable conditions of the craniocervical junction such as atlanto-occipital dislocation (AOD) or atlanto-axial instability (AAI) are severe injuries with a high risk of tetraplegia or death. Immobilization by a cervical collar to protect the patient from secondary damage is a standard procedure in trauma patients. If the application of a cervical collar to a patient with an unstable craniocervical condition may cause segmental motion and secondary injury to the spinal cord is unknown. The aim of the current study is (i) to analyze compression on the dural sac and (ii) to determine relative motion of the cervical spine during the procedure of applying a cervical collar in case of ligamentous unstable craniocervical junction. METHODS AND
findingsLigamentous AOD as well as AOD combined with ligamentous AAI was simulated in two newly developed cadaveric trauma models. Compression of the dural sac and segmental angulation in the upper cervical spine were measured on video fluoroscopy after myelography during the application of a cervical collar. Furthermore, overall three-dimensional motion of the cervical spine was measured by a motion tracking system. In six cadavers each, the two new trauma models on AOD and AOD combined with AAI could be implemented. Mean dural sac compression was significantly increased to -1.1 mm (-1.3 to -0.7 mm) in case of AOD and -1.2 mm (-1.6 to -0.6 mm) in the combined model of AOD and AAI. Furthermore, there is a significant increased angulation at the C0/C1 level in the AOD model. Immense three-dimensional movement up to 22.9° of cervical spine flexion was documented during the procedure.
conclusionThe current study pointed out that applying a cervical collar in general will cause immense three-dimensional movement. In case of unstable craniocervical junction, this leads to a dural sac compression and thus to possible damage to the spinal cord.
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