How effective is the Newport/Aspen collar? A prospective radiographic evaluation in healthy adult volunteers.
BACKGROUND
Cervical extrication collars are used in the evacuation of the injured to minimize secondary injury. These collars were designed for extrication and evacuation, not for longterm use, and complications have been reported when they have been used in the rehabilitation phase. The Newport/Aspen collar was designed specifically for long-term use.


METHODS
Using a radiographic method, the effectiveness of the collar in restricting motion was evaluated for the cervical spine as a whole and for constituent segments, occiput to C7, in 15 normal volunteers.


RESULTS
Combined flexion-extension was reduced from mean 98.8 to 31.1 degrees (31.5% of normal; p = 0.000000002), lateral bending was reduced from mean 31.1 to 15.9 degrees (51.1% of normal; p = 0.0000001), and overhead rotation was reduced from mean 64.6 to 26.8 degrees (41% of normal; p = 0.000000002). The cervical spine, however, does not move as one unit; paradoxical motion, the phenomenon of "snaking," occurs. Goniometric techniques do not demonstrate this effect. Data are provided for motion by segmental level.


CONCLUSIONS
Full cervical immobilization is a myth. It would seem logical to match the level-specific efficacy of the device to the level of injury. Data are provided for the Aspen collar.
Department of Surgery, University of Tennessee Medical Center, Knoxville, USA. steven.hughes@virgin.net
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Hughes
D000293:Adolescent; D000328:Adult; D001915:Braces / Q000009:adverse effects / Q000592:standards*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries / Q000502:physiology*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D014187:Transportation of Patients; D014947:Wounds and Injuries / Q000534:rehabilitation