title: Horizontal Slide Creates Less Cervical Motion When Centering an Injured Patient on a Spine Board.
abstract: BACKGROUND
  A patient with a suspected cervical spine injury may be at risk for secondary neurologic injury when initially placed and repositioned to the center of the spine board.
  
  
  OBJECTIVE
  We sought to determine which centering adjustment best limits cervical spine movement and minimizes the chance for secondary injury.
  
  
  METHODS
  Using five lightly embalmed cadaveric specimens with a created global instability at C5-C6, motion sensors were anchored to the anterior surface of the vertebral bodies. Three repositioning methods were used to center the cadavers on the spine board: horizontal slide, diagonal slide, and V-adjustment. An electromagnetic tracking device measured angular (degrees) and translation (millimeters) motions at the C5-C6 level during each of the three centering adjustments. The dependent variables were angular motion (flexion-extension, axial rotation, lateral flexion) and translational displacement (anteroposterior, axial, and medial-lateral).
  
  
  RESULTS
  The nonuniform condition produced significantly less flexion-extension than the uniform condition (p = 0.048). The horizontal slide adjustment produced less cervical flexion-extension (p = 0.015), lateral bending (p = 0.003), and axial rotation (p = 0.034) than the V-adjustment. Similarly, translation was significantly less with the horizontal adjustment than with the V-adjustment; medial-lateral (p = 0.017), axial (p < 0.001), and anteroposterior (p = 0.006).
  
  
  CONCLUSIONS
  Of the three adjustments, our team found that horizontal slide was also easier to complete than the other methods. The horizontal slide best limited cervical spine motion and may be the most helpful for minimizing secondary injury based on the study findings.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida.
authors.forename: Dewayne N
authors.initials: DN
authors.lastname: DuBose
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida.
authors.forename: Laura Ann
authors.initials: LA
authors.lastname: Zdziarski
authors.affiliation: Florida Cancer Specialist and Research Institute, Fort Myers, Florida.
authors.forename: Nicole
authors.initials: N
authors.lastname: Scott
authors.affiliation: Nike, Inc, Beaverton, Oregon.
authors.forename: Bryan
authors.initials: B
authors.lastname: Conrad
authors.affiliation: Sports Physical Therapy of New York, Buffalo, New York.
authors.forename: Allyson
authors.initials: A
authors.lastname: Long
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York.
authors.forename: Glenn R
authors.initials: GR
authors.lastname: Rechtine
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Texas, Houston, Texas.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Prasarn
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida.
authors.forename: MaryBeth
authors.initials: M
authors.lastname: Horodyski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation* / Q000592:standards* / Q000706:statistics & numerical data; D007593:Joint Instability / Q000150:complications / Q000451:nursing; D008297:Male; D009068:Movement; D055805:Moving and Lifting Patients / Q000379:methods* / Q000451:nursing / Q000706:statistics & numerical data; D019838:Neck Injuries / Q000150:complications; D056888:Patient Positioning / Q000379:methods / Q000592:standards*; D013124:Spinal Injuries / Q000150:complications
keywords: cervical injury; cervical motion; spine board; spine-board centering