Cervical Collar VK
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Neck pain is one of the most prevalent and costly health problems in the United States. It remains a complex, subjective experience with a variety of musculoskeletal causes. Although, cervical collars are a seemingly benign intervention, they can have adverse effects, especially when used for longer periods of time. It is feared that a long period of immobilization, can result in atrophy-related secondary damage. Many physicians cite anecdotal evidence of their clinical utility and soft cervical collars are often prescribed by convention for patients complaining of neck pain. The use of cervical collars to treat neck pain is an area of controversy. This review article examines the current evidence and studies related to recommending cervical collars for neck pain of a variety of etiologies.
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| Information | Most trauma patients in the US arrive at the hospital immobilized [36]. Routinely, this immobilization includes a hard spine board, a cervical collar, and a means to prevent rotation of the head. A hard cervical collar and a firm mattress are the standard means of immobilizing patients with documented unstable injuries in the ED or ICU before application of traction or definitive stabilization. The multicenter National Emergency X-Radiography Utilization Study (NEXUS) enrolled 34,069 patients and determined which trauma patients require radiological clearance of the cervical spine [37]. They determined that only patients with midline neck tenderness, focal neurologic deficits, altered mental status, intoxication, or a painful distracting injury require radiographs to exclude spinal injury. These criteria were 99.6% sensitive for clinically significant injuries. Therefore, if the patient is neurologically intact, alert, without neck tenderness, they can be cleared from the precautions clinically, without obtaining a radiograph.Cervical collars have been found to be helpful in the management of spinal stabilization for atlantoaxial rotatory subluxation (AARS) and various cervical spine fractures. A study by Subach et al. [38] reviewed the management of 20 children (mean age 6.4 years) with AARS. All the patients had presented with torticollis and symptoms of neck pain and decreased cervical motion for a mean of 11.2 days before diagnosis. Five patients were initially treated with a rigid cervical collar and anti-inflamatory agents. A total of 15 patients were treated with cervical traction. All the patients were immobilized post-reduction for approximately 12 weeks. Four of the five patients in the collar group reduced spontaneously, whereas the fifth required cervical traction and eventual fusion for recurrence. Of the 16 patients treated with traction, normal atlantoaxial alignment was restored in 15. We see from this study that rigid cervical collars may play a role successfully managing AARS. |
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