Efficacy of orthotic immobilization of the unstable subaxial cervical spine of the elderly patient: investigation in a cadaver model.

摘要

OBJECTIVE: To assess the efficacy of soft, semirigid and hard cervical collars to immobilize the neck in a destabilized cadaver model. DESIGN: This is a laboratory experiment. SETTING: The anatomy research lab of McMaster University. PATIENTS: None. Fresh cadavers from elderly patients suffering terminal medical illness and free of cervical structural disease were studied. INTERVENTIONS: Destabilizing discoligamentous lesions of the neck were created in the cadavers. Radiographs were taken in maximum displacement in the prone, decubitus and side-bending positions, first unsupported and then with soft, semirigid and hard collars applied. Displacements in angulation and translation were measured from the radiographs. OUTCOME MEASURES: Radiographic displacement under gravity load. RESULTS: In all cases there was no effective limitation of pathological displacement, and in many cases displacement was increased after collar application. CONCLUSIONS: Cervical collars do not effectively support the unstable neck, and may be ineffective in preventing pathological displacements.