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首页> 外文期刊>The Journal of Emergency Medicine >Cervical Collars are Insufficient for Immobilizing an Unstable Cervical Spine Injury.
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Cervical Collars are Insufficient for Immobilizing an Unstable Cervical Spine Injury.

机译：颈托不足以固定不稳定的颈椎损伤。

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BACKGROUND: Cervical orthoses are commonly used for extrication, transportation, and definitive immobilization for cervical trauma patients. Various designs have been tested frequently in young, healthy individuals. To date, no one has reported the effectiveness of collar immobilization in the presence of an unstable mid-cervical spine. STUDY OBJECTIVES: To determine the extent to which cervical orthoses immobilize the cervical spine in a cadaveric model with and without a spinal instability. METHODS: This study used a repeated-measures design to quantify motion on multiple axes. Five lightly embalmed cadavers with no history of cervical pathology were used. An electromagnetic motion-tracking system captured segmental motion at C5-C6 while the spine was maneuvered through the range of motion in each plane. Testing was carried out in intact conditions after a global instability was created at C5-C6. Three collar conditions were tested: a one-piece extraction collar (Ambu Inc., Linthicum, MD), a two-piece collar (Aspen Sierra, Aspen Medical Products, Irvine, CA), and no collar. Gardner-Wells tongs were affixed to the skull and used to apply motion in flexion-extension, lateral bending, and rotation. Statistical analysis was carried out to evaluate the conditions: collar use by instability (3 x 2). RESULTS: Neither the one- nor the two-piece collar was effective at significantly reducing segmental motion in the stable or unstable condition. There was dramatically more motion in the unstable state, as would be expected. CONCLUSION: Although using a cervical collar is better than no immobilization, collars do not effectively reduce motion in an unstable cervical spine cadaver model. Further study is needed to develop other immobilization techniques that will adequately immobilize an injured, unstable cervical spine.
机译：背景：颈椎矫形器通常用于颈椎创伤患者的脱垂，运输和确定性固定。各种设计已在年轻，健康的个人中频繁测试。迄今为止，尚无人报道在颈椎中段不稳定的情况下固定颈圈的有效性。研究目的：确定在有或没有脊柱不稳的尸体模型中，颈椎矫形器固定颈椎的程度。方法：本研究采用重复测量设计来量化多轴运动。使用了五个没有宫颈病理史的轻度防腐的尸体。电磁运动跟踪系统在C5-C6处捕获分段运动，而脊椎则在每个平面的运动范围内进行操纵。在C5-C6产生整体不稳定之后，在完整条件下进行测试。测试了三种领圈条件：一件式领圈（Ambu Inc.，Linthicum，MD），两件套领圈（Aspen Sierra，Aspen Medical Products，Irvine，CA）和无领圈。 Gardner-Wells钳子固定在头骨上，用于屈伸，横向弯曲和旋转运动。进行统计分析以评估条件：不稳定使用项圈（3 x 2）。结果：无论是在固定状态还是在不稳定状态下，一件式或两件式套环都无法有效地减少节段运动。可以预期，在不稳定状态下会有更多的运动。结论：尽管使用颈托比不固定要好，但是在不稳定的颈椎尸体模型中，使用颈托并不能有效地减少运动。还需要进一步研究来开发其他固定技术，以充分固定受伤的不稳定颈椎。

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