A 3D motion analysis study comparing the effectiveness of cervical spine orthoses at restricting spinal motion through physiological ranges

Evans, Nicholas Rhys; Hooper, G.; Edwards, Rachel; Whatling, Gemma Marie; Sparkes, Valerie; Holt, Catherine Avril; Ahuja, Sashin

doi:10.1007/s00586-012-2641-0

Cited by 30 publications

(21 citation statements)

References 22 publications

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“…For the same outcome, we also identified very-low-quality evidence (downgraded for indirectness) from 13 nonrandomized studies [140][141][142][143][144][145][146][147][148][149][150][151][152] Seven additional studies [153][154][155][156][157][158][159] were not included in the final analysis because they were missing data (mean and/or SD of intervention and control group not reported).…”

Section: (Semi)rigid Collar (I) Compared With No Collar (C)mentioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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and curriculum development, and a specialist in first aid evidence evaluation methodology and guideline development.The task force convened in June 2013 to review the topics and questions that were evaluated in 2005 and 2010, past research questions formulated in the PICO style (population, intervention, comparator, outcomes) that were never completed, and the new questions that had been submitted since 2010 to the task force, and a priority list created. Topics were reviewed for areas of controversy, known additional new science, and subject matter not previously evaluated. Task force members created a priority list for review, and the top 10 priority-ranked PICO questions were assigned. After the successful commencement of the workflow, the task force co-chairs added a further 12 PICO questions, including 5 new questions, 1 derived question, and 6 that had been previously reviewed. Selected PICO questions that had been previously reviewed were, in some cases, reworded to facilitate literature searches, and outcomes were decided upon by group consensus.Evidence reviewers were recruited through a call for volunteers distributed by ILCOR to stakeholder organizations around the world. More than 30 individual reviewers were assigned to topics, usually by preference or expertise, but avoiding any direct conflicts of interest. In general, 2 evidence reviewers were assigned to each PICO, supervised by a member of the task force designated as the task force question owner. Evidence reviewers included physicians with diverse specialties including emergency medicine, EMS, wilderness medicine, critical care, cardiology, occupational medicine, toxicology, anesthesia, pediatric emergency medicine, public health, and epidemiology, as well as paramedics, nurse practitioners and first aid education specialists with experience in guideline and curriculum development, and professional evidence evaluation and methodology experts. The Evidence Evaluation ProcessFor the 2015 international evidence evaluation process, the AHA developed a new Web-based information and documentation platform, the Systematic Evidence Evaluation and Review System (SEERS), to support the ILCOR systematic reviews and to capture the data in reusable formats. This Webbased system facilitated structured reviews in a consistent format that would support the ultimate development of science summaries and evidence-based treatment recommendations.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies, 1 using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group.2 After identifying and prioritizing the PICO questions to be addressed, 3 and with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evalu...

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Section: (Semi)rigid Collar (I) Compared With No Collar (C)mentioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

View full text Add to dashboard Cite

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“…However, its results are in line with the results of the studies included in this systematic review; the ability to restrict flexion and extension was substantial (MIL 61-67 %) and fair to moderate for lateral bending (MIL 21-42 %). However, Evans et al [23] reported the ability to restrict rotation to be moderate to substantial (MIL 56-66 %) while the studies included in this systematic review reported a poor to moderate rotational restriction (MIL 13-40 %).…”

Section: Discussionmentioning

confidence: 80%

“…In a 3D motion analysis study by Evans et al [23], the effectiveness of different cervico-high thoracic immobilizers were compared to their ability to restrict spinal motion through physiological ranges. All tested immobilizers were classified as cervico-high thoracic immobilizers (type B 1 : Vista, Miami-J, Miami-J advanced and Philadelphia collar).…”

Section: Discussionmentioning

confidence: 99%

The ability of external immobilizers to restrict movement of the cervical spine: a systematic review

et al. 2016

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Purpose To review the ability of various types of external immobilizers to restrict cervical spine movement. Methods With a systematical review of original scientific articles, data on range of motion, type of used external immobilization device and risk of bias were extracted. The described external immobilization devices were grouped and the mean restriction percentage and standard deviation were calculated. Finally, each device was classified based on its ability to restrict movement of the cervical spine, according to five levels of immobilization: poor (MIL \20 %), fair (MIL 20-40 %), moderate (MIL 40-60 %), substantial (MIL 60-80 %), and nearly complete (MIL C80 %). Results The ability to reduce the range of motion by soft collars was poor in all directions. The ability of cervicohigh thoracic devices was moderate for flexion/extension but poor for lateral bending and rotation. The ability of cervico-low thoracic devices to restrict flexion/extension and rotation was moderate, while their ability to restrict lateral bending was poor. All cranio-thoracic devices for non-ambulatory patients restricted cervical spine movement substantial in all directions. The ability of vests with non-invasive skull fixation was substantial in all directions. No studies with healthy adults were identified with respect to cranial traction and halo vests with skull pins and their ability to restrict cervical movement. Conclusions Soft collars have a poor ability to reduce mobility of the cervical spine. Cervico-high thoracic devices primarily reduce flexion and extension, but they reduce lateral bending and rotation to a lesser degree. Cervico-low thoracic devices restrict lateral bending to the same extent as cervico-high thoracic devices, but are considerably more effective at restricting flexion, extension, and rotation. Finally, cranio-thoracic devices nearly fully restrict movement of the cervical spine.

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“…Numerous studies investigating the kinematics of cervical collars have been published exhibiting the efficacy of these devices in limiting gross cervical flexion, extension, and lateral bending. 30 – 34 Biomechanical studies by Nightingale et al examining the strength of cervical spines have demonstrated that cervical spine structural failure resulting from bending moments occurs at the extremes of cervical range of motion and most commonly occurs due to failure of ligamentous structures. 35 , 36 Since such extremes in range of motion are not achievable while a collar is being worn, and the anterior plate eliminates range of motion across the resected disc space, we elected to forego the testing of bending moments in this preliminary investigation.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Discectomy With Fusion Using a Local Source for Cancellous Autograft: A Biomechanical Analysis of Vertebral Body Stability in an Osteopenic Bone Model

Walterscheid

O’Neill

Ochs

et al. 2017

Geriatr Orthop Surg Rehabil

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Background:Anterior cervical discectomy with fusion is an effective treatment for patients having cervical radiculopathy and myelopathy. To reduce morbidity associated with autograft taken from the iliac crest without sacrificing high fusion rates, a novel technique that harvests bone from the vertebral body adjacent to the operative disc space has been proposed. The effects of square and round bone graft harvest techniques on the mechanical stability of the osteopenic donor vertebrae are unknown. We analyzed the biomechanical implications of the technique by subjecting osteopenic models to uniaxial compression to compare yield strengths of surgically altered and unaltered specimens.Methods:Biomechanical grade polyurethane foam was cut into 60 different 12 mm × 17 mm × 20 mm blocks. The foam had a density of 10 pounds per cubic foot, simulating osteoporotic bone. Rectangular prism (4 mm × 4 mm × 6 mm) and cylindrical cores (r = 2 mm, h = 8 mm) were removed from 20 blocks per group. Twenty samples were left intact as a control group. Anterior plate screws were applied to the models and a Polyether ether ketone (PEEK) interbody spacer was placed on top. Samples underwent uniaxial compression at 0.1 mm/s until mechanical failure. Points of structural failure were determined using a 0.1% offset on a force–displacement curve and compared to determine the reductions in compressive strength.Results:The mean force eliciting structural failure for intact samples was 450.6 N. Average failure forces for rectangular prisms and cylindrical cores removed were 383.2 and 395.4 N, respectively. Removal of a rectangular prismatic core of the necessary volume resulted in a 15.0% reduction in compressive strength, while removal of a cylindrical core of comparable volume facilitated a reduction of 12.2%.Conclusion:Local autograft harvested from adjacent vertebrae reduces morbidity associated with a second surgical site while minimally reducing the compressive strength of the donor vertebra in an osteopenic model, lending credence to the efficacy of this technique in elderly patient populations.

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A 3D motion analysis study comparing the effectiveness of cervical spine orthoses at restricting spinal motion through physiological ranges

Abstract: Our motion analysis study found the Aspen collar to be superior to the other collars when measuring restriction of movement of the cervical spine in all planes, particularly the sagittal and transverse planes, while the Aspen Vista was the least effective collar.

Cited by 30 publications

References 22 publications

Part 9: First Aid

Part 9: First Aid

The ability of external immobilizers to restrict movement of the cervical spine: a systematic review

Anterior Cervical Discectomy With Fusion Using a Local Source for Cancellous Autograft: A Biomechanical Analysis of Vertebral Body Stability in an Osteopenic Bone Model

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