Motion is reduced in the unstable spine with the use of mechanical devices for bed transfers

Abstract

ContextExcessive spinal motion generated during multiple bed transfers of patients with unstable spine injuries may contribute to neurological deterioration.ObjectiveTo evaluate spinal motion in a cadaveric model of global spinal instability during hospital bed transfers using several commonly used techniques.Design/participantsA motion analysis and evaluation of hospital bed transfer techniques in a cadaveric model of C5–C6 and T12–L2 global spinal instability.Setting/outcome measuresGlobal instability at C5–C6 and T12–L2 was created. The motion in three planes was measured in both the cervical and lumbar spine during each bed transfer via electromagnetic motion detection devices. Comparisons between transfers performed using an air-assisted lateral transfer device, manual transfer, a rolling board, and a sliding board were made based on the maximum range of motion observed.ResultsSignificantly less lateral bending at C5–C6 was observed in air-assisted device transfers when compared with the two other boards. Air-assisted device transfers produced significantly less axial rotation at T12–L2 than the rolling board, and manual transfers produced significantly less thoracolumbar rotation than both the rolling and sliding boards. No other significant differences were observed in cervical or lumbar motion. Motion versus time plots indicated that the log roll maneuvers performed during rolling board and sliding board transfers contributed most of the observed motion.ConclusionsEach transfer technique produced substantial motion. Transfer techniques that do not include the logroll maneuver can significantly decrease some components of cervical and lumbar motion. Thus, some spinal motion can be reduced through selection of transfer technique.