Effectiveness and safety of techniques for cervical spine immobilization in mountain rescue

Abstract Background Cervical spine injuries in alpine sports require immediate immobilization at the site of the accident to avoid possible secondary damage caused by transportation. Using special sensor technology, this study investigated whether a cervical spine orthosis (cervical collar, Stifneck collar (Laerdal Medical GmbH, Puchheim, Germany)) provides greater stability than a vacuum mattress alone. Methods Using one male test person, we simulated transporting a patient with a spinal injury in steep alpine terrain. A wireless motion capture system (Xsens Technologies, Movella™ Inc., Henderson, USA) was used to record motion in three-dimensional space within a standardized environment. All tests were performed on a set course by the Bavarian Mountain Rescue Service. The test person lay on a mountain rescue stretcher and was immobilized with a vacuum mattress, either with or without a cervical orthosis. The axes of cervical spine movements were analyzed separately. Results There were no significant differences between immobilization with and without a cervical orthosis with regard to lateral flexion (max. 3.7° compared to 3.0°) in the frontal plane and maximum excursion in flexion (max. 1.6° compared to 2.8°) or extension (max. -1.6° compared to -1.7°). There was significantly greater rotation movement around the craniocaudal axis without an orthosis (max. 2.4° compared to 1.3°). Conclusion During mountain rescues, the cervical spine can be immobilized without a rigid cervical spine orthosis. Future research should explore the fundamental benefits of cervical spine immobilization, while the findings of this work contribute to the safe care of patients by avoiding the disadvantages associated with rigid cervical orthoses.