The application of a cervical collar on a trauma victim can cause more harm to the patient, leading to secondary injuries or even death, according to experts at Baylor College of Medicine in a study that appears in the current online edition of the Journal of Trauma.
"Cervical extrication collars are put on about 15 million times a year in the United States alone by emergency medical personnel or doctors in hospitals to protect the cervical spine in case of a bad injury. It is known that after a person has a bad injury, you can create a secondary injury very easily," said Dr. John Hipp, assistant professor of orthopedic surgery at BCM and senior author of the paper. "We have discovered that the cervical collar, in the case of a really bad injury, not only doesn't protect the spine but can actually make things a lot worse."
Researchers simulated dissociative injuries, injuries in which there is a separation between two segments in the neck due to a ruptured ligament, in nine cadavers, and then applied cervical collars based on standard Emergency Medical Services protocol. Using a variety of imaging technologies, they found that applying the cervical collar caused an abnormal increased separation between the vertebrae at the injury level.
"We found that the cervical collar tends to pull the head away from the torso, which can create a separation and lead to secondary injury," said Dr. Peleg Ben-Galim, assistant professor of orthopedic surgery at BCM, and lead author of the study.
Cause of secondary injuries
These secondary injuries can lead to quadriplegia or even death.
"The cervical collars may not be the best option in all cases," said Ben-Galim.
There needs to be additional research to see whether another stabilization method can help avoid this separation between the vertebrae, said Hipp.
Others who participated in the study include Drs. Kenneth Mattox and Charles Reitman of BCM, and Drs. Niv Dreiangel and S. Babak Kalantar, who were at BCM at the start of the research.
Funding for this study came from BCM's Department of Orthopedic Surgery and the Benjamin Ford Kitchen Professorship in Orthopedic Surgery.