Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury
Version of Record online: 28 JUN 2008
Academic Emergency Medicine
Volume 5, Issue 3, pages 214–219, March 1998
How to Cite
Hauswald, M., Ong, G., Tandberg, D. and Omar, Z. (1998), Out-of-hospital Spinal Immobilization: Its Effect on Neurologic Injury. Academic Emergency Medicine, 5: 214–219. doi: 10.1111/j.1553-2712.1998.tb02615.x
- Issue online: 28 JUN 2008
- Version of Record online: 28 JUN 2008
- Received: February 19, 1997; revision received: July 10, 1997; accepted: July 17, 1997; updated: October 23, 1997.
- back board;
- emergency medical services;
- spinal cord
Objective: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries.
Methods: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables.
Results: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03–3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64–3.62; p = 0.34).
Conclusion: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.