Increased risk of death with cervical spine immobilisation in penetrating cervical trauma

Should suspected cervical spinal cord injury be immobilised?: A systematic review

“…The authors reported that c-spine immobilisation was associated with an unadjusted higher risk of death compared to non-immobilisation in isolated cervical spine injuries (n = 107), (OR, 8.82; 95% CI, 1.09-194; p = 0.038). It was also associated with an unadjusted increased risk of mortality among all subjects (n = 188) included in the study (OR, 2.77; 95% CI, 1.18-6.49; p = 0.016) [33].…”

“…In addition, c-spine immobilisation was associated with an unadjusted increased risk of cardiopulmonary resuscitation (CPR) on arrival to emergency department (OR, 3.53; 95% CI, 1.06-12.95; p = 0.037) [33]. The authors suggest possible reasons for this association may include masking of important clinical signs, blocked access to injury sites, and impaired intubation [33].…”

“…These studies concluded that c-collar application may result in increased mortality rates [33,34], concealment of neck injuries [35], increased scene time [36], and that the use of a ccollar has no or minimum benefits in penetrating trauma [33,34,36]. While in blunt trauma, three retrospective observational studies and one case study (suicide by hanging) reported on outcomes associated with c-collar application following blunt trauma.…”

“…Findings are summarised in a thematic manner in the following sections. The authors reported a total mortality rate of 23% (35/153), with 94% of injuries due to gunshot wounds (GSW), and a predominantly male population (91%; 32/35) [33].…”

“…The authors suggest possible reasons for this association may include masking of important clinical signs, blocked access to injury sites, and impaired intubation [33].…”