title: A comparative study of American football helmet removal techniques using a cadaveric model of cervical spine injury.
abstract: BACKGROUND
  American football is the source of a significant number of cervical spine injuries. Removal of the helmets from these individuals is often problematic and presents a potential for exacerbation of the injury. There are two widely recognized helmet removal techniques that are currently in practice. In this study, the two methods are compared for cervical movement and potential for cord injury to determine their relative efficiency and clinical utility.
  
  
  METHODS
  A single cadaver with a simulated cervical injury was used to compare the National Athletic Trainers' Association (NATA) and cast saw techniques of helmet removal. Directed lateral fluoroscopy was used to measure the relative changes in angulation, translation, distraction, and space available to the spinal cord during helmet removal using the two techniques as performed by medical personnel with limited training in the methods.
  
  
  RESULTS
  By radiologists' reports, there were no detectable changes in disc height, translation or space available for the spinal cord during helmet removal with either of the studied techniques. Operators noted that the noise of the cast saw would probably be significantly uncomfortable for any live subject inside of a helmet.
  
  
  CONCLUSIONS
  Both the NATA and cast saw methods appear effective for the safe removal of a football helmet and with little risk of further injury to the cervical spine. Considering the simplicity and efficiency of the NATA helmet removal technique, the authors conclude that the NATA technique should be the preferred helmet removal method.
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Anderson
authors.forename: Brian
authors.initials: B
authors.lastname: Tollefson
authors.forename: Rob
authors.initials: R
authors.lastname: Cohen
authors.forename: Jeremy
authors.initials: J
authors.lastname: Johnson
authors.forename: Richard L
authors.initials: RL
authors.lastname: Summers
mesh_terms: D002102:Cadaver; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000502:physiology; D005471:Fluoroscopy; D005538:Football / Q000293:injuries*; D006260:Head Protective Devices; D006801:Humans; D009068:Movement; D013119:Spinal Cord Injuries / Q000517:prevention & control*; D019876:Sports Equipment; D014743:Videotape Recording