title: Helmet and shoulder pad removal in suspected cervical spine injury: human control model.
abstract: METHODS
  Digital fluoroscopy was used to evaluate the motion in normal men during helmet and shoulder pad removal.
  
  
  OBJECTIVE
  To observe the amount of motion that occurs during the removal of helmet and shoulder pads in an uninjured spine.
  
  
  BACKGROUND
  Removal of shoulder pads and helmet from a football player with suspected cervical spine injury can be particularly hazardous. Previous studies have been performed in cadavers with known created injuries. No control study in uninjured players has been done to show if there is similar motion with removal of football equipment.
  
  
  METHODS
  Four people removed the helmet and shoulder pads with a technique consistent with that described by the National Athletic Trainers' Association (NATA). Before positioning, with the helmet and shoulder pads on the subject and the subject lying flat on the table, one static lateral image was obtained as a baseline. With the neck stabilized and everyone in position, the torso, head, and neck were elevated approximately 30-40 degrees off the table bending at the waist. After elevation, continuous fluoroscopy was turned on as the helmet and shoulder pads were removed. Once the equipment was removed, the subject was carefully placed back down on the table and a final static lateral image was obtained. All images were saved digitally. Measurements were made for change in angulation, translation, distraction, and space available for the cord.
  
  
  RESULTS
  The results for change in disc height, translation, and space available for the cord showed no significant change. The results for change in angulation also did not show any significant motion in either flexion or extension from baseline or between each step in the protocol.
  
  
  CONCLUSIONS
  In the conscious player with no cervical injury the protocol used by the NATA is effective in limiting cervical motion.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania, USA. Mperis1988@aol.com
authors.forename: Marshal D
authors.initials: MD
authors.lastname: Peris
authors.forename: William F
authors.initials: WF
authors.lastname: Donaldson WF
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Towers
authors.forename: Rob
authors.initials: R
authors.lastname: Blanc
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Muzzonigro
mesh_terms: D001265:Athletic Injuries / Q000517:prevention & control*; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005471:Fluoroscopy / Q000379:methods; D006260:Head Protective Devices / Q000009:adverse effects; D006801:Humans; D008297:Male; D008954:Models, Biological; D009333:Neck / Q000000981:diagnostic imaging / Q000502:physiology; D019838:Neck Injuries / Q000209:etiology / Q000517:prevention & control*; D011481:Protective Clothing / Q000009:adverse effects / Q000592:standards; D011856:Radiographic Image Enhancement / Q000379:methods / Q000592:standards; D016059:Range of Motion, Articular; D012782:Shoulder / Q000502:physiology; D013124:Spinal Injuries / Q000209:etiology / Q000517:prevention & control*