title: Motion in the unstable thoracolumbar spine when spine boarding a prone patient.
abstract: BACKGROUND
  Previous research has found that the log roll (LR) technique produces significant motion in the spinal column while transferring a supine patient onto a spine board. The purpose of this project was to determine whether log rolling a patient with an unstable spine  from prone to supine with a pulling motion provides better thoracolumbar immobilization compared to log rolling with a push technique.
  
  
  METHODS
  A global instability was surgically created at the L1 level in five cadavers. Two spine-boarding protocols were tested (LR Push  and LR Pull). Both techniques entailed performing a 180° LR rotation of the prone patient from the ground to the supine position on the spine board. An electromagnetic tracking device registered motion between the T12 and L2 vertebral segments. Six motion parameters were tracked. Repeated-measures  statistical analysis was performed to evaluate angular and translational motion.
  
  
  RESULTS
  Less motion was produced during the LR Push compared to the LR Pull for all six motion parameters. The difference was statistically significant for three of the six parameters (flexion-extension,  axial translation, and anterior-posterior (A-P) translation).
  
  
  CONCLUSIONS
  Both the LR Push and LR Pull generated significant motion in the thoracolumbar spine during the prone to supine LR. The LR Push technique produced statistically less motion than the  LR Pull, and should be considered when a prone patient with a suspected thoracolumbar injury needs to be transferred to a long spine board. More research is needed to identify techniques to further reduce the motion in the unstable spine during prone to supine LR.
authors.affiliation: College of Medicine, University of Florida, FL, USA. bconrad@ufl.edu
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Conrad
authors.forename: Diana L
authors.initials: DL
authors.lastname: Marchese
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Rechtine
authors.forename: Marybeth
authors.initials: M
authors.lastname: Horodyski
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology*; D009038:Motion; D016684:Prone Position; D016059:Range of Motion, Articular / Q000502:physiology; D013122:Spinal Diseases / Q000503:physiopathology*; D014187:Transportation of Patients / Q000379:methods* / Q000592:standards