title: Efficacy of orthotic immobilization of the unstable subaxial cervical spine of the elderly patient: investigation in a cadaver model.
abstract: OBJECTIVE
  To assess the efficacy of soft, semirigid and hard cervical collars to immobilize the neck in a destabilized cadaver model.
  
  
  METHODS
  This is a laboratory experiment.
  
  
  METHODS
  The anatomy research lab of McMaster University.
  
  
  METHODS
  None. Fresh cadavers from elderly patients suffering terminal medical illness and free of cervical structural disease were studied.
  
  
  METHODS
  Destabilizing discoligamentous lesions of the neck were created in the cadavers. Radiographs were taken in maximum displacement in the prone, decubitus and side-bending positions, first unsupported and then with soft, semirigid and hard collars applied. Displacements in angulation and translation were measured from the radiographs.
  
  
  METHODS
  Radiographic displacement under gravity load.
  
  
  RESULTS
  In all cases there was no effective limitation of pathological displacement, and in many cases displacement was increased after collar application.
  
  
  CONCLUSIONS
  Cervical collars do not effectively support the unstable neck, and may be ineffective in preventing pathological displacements.
authors.affiliation: Division of Orthopedic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. spinopod@allstream.net
authors.forename: Drew A
authors.initials: DA
authors.lastname: Bednar
mesh_terms: D000368:Aged; D001368:Axis, Cervical Vertebra; D002102:Cadaver; D006801:Humans; D007103:Immobilization; D007593:Joint Instability / Q000628:therapy*; D009989:Orthotic Devices