Effect of the Log-Rolling Maneuver on the Unstable Fracture Spine

Rao, S.; Parikh, Shital N.; Kumar, Janani Anand; McGuire, Paula

doi:10.1097/00005131-199212000-00051

Cited by 2 publications

(3 citation statements)

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“…The only human study [ 35 ] reported on eighteen patients with thoracic or lumbar spinal fractures. The outcome measure was the proportion of patients with “significant displacement” in the fracture when turning the patient from the supine to a lateral position in a controlled manner (“logroll maneuver”).…”

Section: Resultsmentioning

confidence: 99%

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Does turning trauma patients with an unstable spinal injury from the supine to a lateral position increase the risk of neurological deterioration? – A systematic review

Hyldmo

Vist

Feyling

et al. 2015

Scand J Trauma Resusc Emerg Med

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BackgroundAirway protection and spinal precautions are competing concerns in the treatment of unconscious trauma patients. The placement of such patients in a lateral position may facilitate the acquisition of an adequate airway. However, trauma dogma dictates that patients should be transported in the supine position to minimize spinal movement. In this systematic review, we sought to answer the following question: Given an existing spinal injury, will changing a patient’s position from supine to lateral increase the risk of neurological deterioration?MethodsThe review protocol was published in the PROSPERO database (Reg. no. CRD42012001190). We performed literature searches in PubMed, Medline, EMBASE, the Cochrane Library, CINAHL and the British Nursing Index and included studies of traumatic spinal injury, lateral positioning and neurological deterioration. The search was updated prior to submission. Two researchers independently completed each step in the review process.ResultsWe identified 1,164 publications. However, none of these publications reported mortality or neurological deterioration with lateral positioning as an outcome measure. Twelve studies used movement of the injured spine with lateral positioning as an outcome measure; eleven of these investigations were cadaver studies. All of these cadaver studies reported spinal movement during lateral positioning. The only identified human study included eighteen patients with thoracic or lumbar spinal fractures; according to the study authors, the logrolling technique did not result in any neurological deterioration among these patients.ConclusionsWe identified no clinical studies demonstrating that rotating trauma patients from the supine position to a lateral position affects mortality or causes neurological deterioration. However, in various cadaver models, this type of rotation did produce statistically significant displacements of the injured spine. The clinical significance of these cadaver-based observations remains unclear. The present evidence for harm in rotating trauma patients from the supine position to a lateral position, including the logroll maneuver, is inconclusive.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-015-0143-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…The proportion of patients with “significant displacement” varied from 0/18 to 6/18 in the various planes. However, according to the authors, “none of the patients suffered any neurological deficit as a result of the logrolling technique.” [ 35 ]…”

Section: Resultsmentioning

confidence: 99%

Does turning trauma patients with an unstable spinal injury from the supine to a lateral position increase the risk of neurological deterioration? – A systematic review

Hyldmo

Vist

Feyling

et al. 2015

Scand J Trauma Resusc Emerg Med

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“…20 It is also commonly used to transfer patients with SCI from a backboard to a bed. Properly performed, the log-roll maneuver requires at least two trained medical professionals.…”

Section: Discussionmentioning

confidence: 99%

Log-rolling technique producing unacceptable motion during body position changes in patients with traumatic spinal cord injury

Conrad

Horodyski

Wright

et al. 2007

SPI

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Object The purpose of the present study was to compare spinal motion generated during log-rolling and kinetic therapy with that generated when using a kinetic treatment table (KTT). The authors' hypothesis was that the KTT would produce less spinal motion while maintaining the benefits of body position changes. Methods Cervical and lumbar instability was created in three fresh, unembalmed cadavers. Electromagnetic sensors were fixed to the C5–6 and T12–L2 segments to measure cervical and lumbar spine segmental motion. Body position changes were performed using the traditional log-roll method and a KTT. Spinal motion was measured during each maneuver. Turning the cadaveric specimens on the KTT bed caused significantly less cervical motion than the log-roll technique as measured in flexion and axial rotation. The log-roll technique caused significantly greater cervical motion during body position changes than turning using the KTT. Conclusions Although the global instability will require surgical stabilization, consideration should be given to initial immobilization on a KTT to decrease the likelihood of secondary injury.

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Effect of the Log-Rolling Maneuver on the Unstable Fracture Spine

Cited by 2 publications

References 0 publications

Does turning trauma patients with an unstable spinal injury from the supine to a lateral position increase the risk of neurological deterioration? – A systematic review

Does turning trauma patients with an unstable spinal injury from the supine to a lateral position increase the risk of neurological deterioration? – A systematic review

Log-rolling technique producing unacceptable motion during body position changes in patients with traumatic spinal cord injury

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