Use Of Cervical Collar Research Articles

Prehospital use of spinal precautions by emergency medical services in children and adolescents.

Limited evidence exists to guide the management of children with possible spinal injuries in the prehospital setting. As a first step to address this, we set out to describe the epidemiology and management of children <18 years presenting with possible cervical spinal injuries to EMS in Victoria, Australia. Retrospective case record review of all children with concerns of head or neck trauma and/or documented cervical spine collar use presenting to the statewide Ambulance Victoria (AV) EMS service, Victoria, Australia, between 1 July 2019 and 30 June 2020. Demographic, clinical features, mechanism of injury and spinal immobilisation practices were extracted. 2100 children were included; 61% were male and the median age was 13 years (interquartile range: 9-15). Over half of the children were transported to suburban (32.2%) and rural/regional (22.9%) EDs, with 37.5% taken to designated trauma centres. The most common mechanisms of injury were sports/activity, motor vehicle accidents and falls in 35.4%, 27.9% and 26.3%, respectively. Spinal precaution use was recorded in 93.7% of cases; cervical collar use was the most common procedure recorded (87.1%). Younger age groups were less likely to have spinal precautions initiated; 51% of children aged 0-3 years, compared to 96.3% of children aged 12 and older (odds ratio = 23.8; 95% confidence interval = 14.5-37; P < 0.001). Prehospital spinal precautions were initiated commonly in children, with use increasing with age, and most were transported to suburban, regional and rural hospitals, not trauma centres. These data will inform the integration of emerging paediatric-specific evidence into prehospital guidelines to risk stratify children.

Cervical Collar Use Following Cervical Spine Surgery: A Systematic Review.

The utility and risks associated with the use of cervical collars in the postoperative period after cervical spine surgery have been of debate. The purpose of this study was to systematically review the currently available evidence on the use of cervical collars after cervical spine surgery to assess their impact on outcomes. A literature search of the PubMed database was performed using keywords "cervical collar," "anterior cervical discectomy and fusion (ACDF)," "posterior cervical decompression and fusion," "laminoplasty," "post-operative orthotic bracing," "cervical decompression," and "cervical orthosis" in all possible combinations. All English studies with the level of evidence of I to IV that were published from May 1, 1986, to December 3, 2023, were considered for inclusion. A total of 25 articles meeting the inclusion criteria were identified and reviewed. Regarding anterior and posterior fusion procedures, cervical collar use demonstrated improved short-term patient-reported outcomes and pain control. While surgeon motivation for collar use was to increase fusion rates, this is not well drawn out in the literature with the majority of studies demonstrated no significant difference in fusion rates between patients who wore a cervical collar and those who did not. Regarding motion-preserving procedures such as cervical laminoplasty, patients with prolonged postoperative cervical collar use demonstrated increased rates of axial neck pain and decreased final range of motion (ROM). Surgeon motivation for postoperative cervical collar immobilization after completion of fusion procedures is to increase fusion rates and improve postoperative pain and disability despite this not being fully drawn out in the literature. After completion of motion-sparing procedures, the benefits of collar immobilization diminish with their prolonged use which could lead to increased rates of axial neck pain and decreased ROM. Cervical collar immobilization in the postoperative period should be considered its own intervention, with its own associated risk-benefit profile. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cervical collar use in spinal cord injury management

AbstractBackgroundThe use of cervical collars in the management of acute cervical spine injuries has been part of standard practice in the trauma setting for decades, aimed at preventing secondary injuries.ObjectivesTo review the recent evidence challenging the routine use of cervical collars, addressing the limited scientific support, associated risks, and guidelines for their use.MethodsA comprehensive literature review was conducted, analyzing recent studies and guidelines from authoritative bodies such as the American Association for Neurological Surgeons and the Congress of Neurological Surgeons. The review focused on the efficacy, risks, and recommendations regarding cervical collar use in acute cervical spine injuries.ResultsRecent evidence questions the routine use of cervical collars, highlighting limited scientific support and several associated risks, including pressure ulcers and decreased venous return. Cervical collars may also be contraindicated in individuals with abnormal spinal structures, such as those with Ankylosing Spondylitis. The efficacy of cervical collars is debated, particularly concerning undiagnosed spinal fractures, where delayed diagnosis can result in permanent injuries. Despite these risks, cervical collars may be beneficial in low‐resource areas and when used effectively with early clearance post‐injury. Current guidelines recommend immobilizing patients suspected of cervical spine injury but stress the importance of proper evaluation of the need for immobilization. Recent guidelines advocate for spinal motion restriction over traditional immobilization, emphasizing the need for better risk assessment and implementation strategies.Conclusions/Clinical ImportanceRe‐evaluating the routine use of cervical collars is crucial due to potential risks and limited supporting evidence, with a focus on individualized assessment and adherence to updated guidelines favoring spinal motion restriction.

Use of Soft Cervical Collar Improves Surgeon Ergonomics During Simulated Otologic Surgery.

To determine whether surgeon use of a soft cervical collar during endoscopic and microscopic otologic surgery is feasible and impacts surgeon ergonomics as measured by inertial sensors. Prospective crossover trial. US-based otolaryngology training program. Otolaryngology residents and fellows. Therapeutic-use of a soft cervical collar during simulated otologic surgery. Time spent in high-risk angles of neck and back flexion and extension; average angle of neck flexion, extension, rotation, and lateral bending; validated assessment of neck pain; average daily phone use. Fifteen subjects met criteria for inclusion. Ten of 15 (67%) were male. Seven of 15 (47%) were postgraduate year 1-2. Seven of 15 (47%) reported a history of neck pain. None reported prior spinal steroid injections or surgery. Across all subjects, use of the soft cervical collar significantly reduced time spent in high-risk angles of neck flexion/extension during both endoscopic (56% vs. 35%, p < 0.05) and microscopic (60% vs. 32%, p < 0.05) otologic surgery. There was no effect on back flexion or extension. There was no difference in time spent in high-risk neck or back angles between endoscopic and microscopic surgery. Average angles of neck or back flexion, extension, lateral bending, and rotation were not significantly different for subgroups with more operative experience, increased phone use, perception of good posture, or history of neck pain. Use of a soft cervical collar during simulated otologic surgery significantly reduced time spent in high-risk neck positions. These data support feasibility of soft collar use during otologic surgery and hold promise for reduction in the high rates of neck pain reported by neurotologists. Improving surgeon ergonomics for otologic surgery. To identify a therapeutic intervention to mitigate neck pain in surgeons caused by assumption of high-risk cervical neck flexion and extension. To demonstrate that use of a readily available soft cervical collar reduces risk of neck pain in otologic surgeons. II. Exempt.

Hot off the press: Prehospital cervical spine immobilization.

Pre-hospital care of patients with potential cervical spine injuries has evolved over time from strict spinal immobilization (SI) with a hard collar and spine board to spinal motion restriction (SMR) with more variable use of cervical collars and patient positioning. There is limited research describing how these changes have been implemented. This study describes and analyzes the practice of SI/SMR in an urban Canadian Emergency Medical Service. We provide critical analysis of the article and summarize the social media discussion and a podcast in which the authors discuss their work.

Cervical Collar-Associated Pressure Injury in Pediatric Trauma Patients: A Western Pediatric Surgery Research Consortium Study

BackgroundHealthcare-associated pressure injuries (HAPI) are known to be associated with medical devices and are preventable. Cervical spine immobilization is commonly utilized in injured children prior to clinical clearance or for treatment of an unstable cervical spinal injury. The frequency of HAPI has been quantified in adults with cervical spine immobilization but has not been well-described in children. The aim of this study was to describe characteristics of children who developed HAPI associated with cervical immobilization. MethodsWe analyzed a retrospective cohort of children (0–18 years) who developed a stage two or greater cervical HAPI. This cohort was drawn from an overall sample of 49,218 registry patients treated over a five-year period (2017–2021) at ten pediatric trauma centers. Patient demographics, injury characteristics, and cervical immobilization were tabulated to describe the population. ResultsThe cohort included 32 children with stage two or greater cervical HAPI. The median age was 5 years (IQR 2–13) and 78% (n = 25) were admitted to the intensive care unit. The median (IQR) time to diagnosis of HAPI was 11 (7–21) days post-injury. The majority of cervical HAPI (78%, 25/32) occurred in children requiring immobilization for cervical injuries, with only four children developing HAPI after wearing a prophylactic cervical collar in the absence of a cervical spine injury. ConclusionAdvanced-stage HAPI associated with cervical collar use in pediatric trauma patients is rare and usually occurs in patients with cervical spine injuries requiring immobilization for treatment. More expedient cervical spine clearance with MRI is unlikely to substantially reduce cervical HAPI in injured children. Level of EvidenceLevel III (Epidemiologic and Prognostic).

Knowledge, attitude, and practices regarding cervical collars in adult trauma patients amongst practitioners at three hospitals in KwaZulu-Natal, South Africa

BackgroundThe use of cervical collars in adult patients with possible injuries to the cervical spine has been an accepted standard of care for many years, despite the absence of evidence for the efficacy of these devices in preventing unwanted movement and harm. Changes to the terminology and recommendations of major trauma guidelines have been made but are limited by low quality evidence. In this context, little is known about what practitioners know, believe, and do, when managing the cervical spine of trauma patients. MethodsIn this quantitative, observational, descriptive, cross-sectional survey a specifically designed questionnaire was used to collect data on the knowledge, attitude, and practices of practitioners managing adult trauma patients regarding cervical collars at three hospitals in KwaZulu-Natal, South Africa. ResultsA total of 128 completed questionnaires were collected, captured, and analysed. Participants with the additional qualification of ATLS and DipPEC had a mean knowledge score of 8.1 (SD=1.70), compared to those with no additional qualification of 4.5 (SD=1.9) (p<0.001). Participants in the Emergency Department (ED) attained a mean knowledge score of 7.1 (SD=2.2) followed by Surgery (Mean=6, SD=2.0), Orthopaedics (Mean=5.5, SD=1.7) and ICU/Anaesthetics (Mean=4.4, SD=1.8), p<0.001. Head blocks only were most frequently used by 97.4 % of ED, 55.6 % of Surgery, 3.8 % Orthopaedic and 22.2 % ICU/Anaesthetics participants (p<0.001). ConclusionThe knowledge of management principles of cervical spine injuries was influenced by the department in which practitioners worked, the frequency that they managed patients with suspected injuries and additional courses. Head blocks were the most frequently used spinal protection device in all three hospitals. Most participants would be open to a change in practice if new guidelines were recommended. Further research is needed to determine the optimal management of patients with suspected cervical spine injuries and the role of motion restriction devices in limiting movement of the injured spine.

C1-C2 subluxation in enthesitis-related arthritis: two case reports and literature review of ten cases

BackgroundC1-C2 subluxation is a rare complication of enthesitis-related arthritis (ERA). If left untreated, it may lead to functional impairment or cervical spinal cord compression. This study aims to highlight key points regarding the management of C1-C2 subluxation in ERA.Case presentationWe present two cases of C1-C2 subluxation: an 8-year-old boy with ERA and 16-year-old boy with ERA with bilateral sacroiliitis. Ten cases of ERA in the literature were reviewed. The diagnosis of C1-C2 subluxation is mostly based on radiographs and cervical spine computed tomography. All patients were treated with non-steroidal anti-inflammatory drugs. Six ERA patients were treated surgically for cervical fusion. Most ERA patients with sacroiliitis had cervical collar protection. Neurologic abnormalities after treatment were not reported. Despite the use of cervical collar, cervical fusion and persisting ankylosis were found in two ERA patients with sacroiliitis without surgical treatment.ConclusionsCervical spine protection and ruling out spinal cord compression should be prioritized, in addition to controlling the underlying inflammation in ERA. Cervical halter traction may be applied after severe cervical inflammation is excluded. To reduce the risk of complications, early recognition and appropriate treatments of C1-C2 subluxation in ERA are essential.

Cervical collar use following anterior cervical hybrid surgery: protocol for a prospective randomized, time-controlled trial

IntroductionCervical hybrid surgery (HS) combines anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) to establish an individualized surgical plan for patients with multiple cervical disc degenerative diseases. In order to maintain the stability of the spine after HS, an external cervical collar is often used. However, there is still controversy regarding the importance of a cervical collar following surgery. This study aims to determine whether the cervical collar is effective and how long it should be worn after surgery.MethodsThis is a randomized, single-center, prospective, parallel-controlled trial. Eligible participants will be selected according to the inclusion and exclusion criteria. The primary outcome is the neck disability index, which will be evaluated before surgery and at one week, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months following surgery. The secondary outcomes consist of the Japanese Orthopedic Association Scores, MOS 36-item short-form health survey (SF-36), visual analog scale, Pittsburgh Sleep Quality Index (PSQI), Bazaz dysphagia scoring system, Falls Efficacy Scale, cervical collar satisfaction score, neck soft tissue assessment, and Braden Scale, as well as radiologic assessments for cervical lordosis, disc height of the operative levels, fusion rate, range of motion (ROM), and complications including anterior bone loss, prosthesis migration, and heterotopic ossification. The clinical and radiologic examinations were performed by investigators with no therapeutic relationship with the individual patient. All radiographs were examined by one independent radiologist.Ethics and disseminationThe results of this study will be published in peer-reviewed journals and presented at conferences. Upon completion of this trial, our findings could provide an appropriate cervical collar-wearing guideline for patients receiving HS.Trial registrationChiCTR.org.cn ChiCTR2000033002. Registered on 2020–05-17.

Investigating the Rate and Affecting Factors of Unnecessary Cervical Collar Use in Trauma Patients.

This study aimed to investigate the necessity of cervical collars in patients with neck problems. This cross-sectional study was conducted on 114 patients who were admitted to the Haft Tir and Rasoul Akram Hospitals (Tehran, Iran) from August to September 2022. The Nexus protocol was used to select the patients with cervical collars. According to the protocol, a cervical collar was required for individuals who had at least one symptom. If none of these symptoms existed, the cervical collar was deemed unnecessary. The data were analyzed using the Chi-square test and Fisher's exact test. Of the 114 trauma patients, the cervical collar was used unnecessarily by 49 (43%) patients. Tenderness was the most common complication in 62 patients (54.4%). The prevalence of unnecessary cervical collar use was 37.5% in female trauma patients and 43.88% in male trauma patients, which was not statistically significant (p=0.63). The prevalence of unnecessary cervical collar use in trauma patients with multiple trauma was 39.42% and 80% in patients without multiple trauma, which was statistically significant (p=0.018). Patients with a medical history had a higher rate of unnecessary use of the cervical collar (47.96%) than those without a history (12.5%), and this difference was statistically significant (p=0.008). The guidelines for using cervical collars need to be updated by the EMS. Due to the large number of trauma patients in Iran, cervical collars for necessary conditions can help to reduce the healthcare expenses and injuries caused by unnecessary cervical collars.

Physiotherapy Rehabilitation in Cerebellar Stroke: A Case Study

Cerebellar stroke presents a challenging task for rehabilitation. The patient in this case study was a 61-year-old man with a diagnosis of posterior circulation ischaemic stroke. He was referred to our physiotherapy outpatient unit in a major tertiary hospital in Nigeria about two years ago. Patient could not sit up from lying, nor stand or walk independently. Visible and palpable tremors were observed in the entire body but more pronounced in the head, neck and shoulders (titubation). Patient could not perform self-care activities; there was difficulty with speech, language and communication. The treatment included free active exercises, mat exercises, bridging, rolling and sitting and standing balance training, breathing exercises, bicycling, walking within parallel bars, wobble board, facial massage, strengthening exercises, cervical collar use and home programme. Involved repetition of treatment session activities taught to his caregivers who were ascertained competent to effect. Treatment was structured into short term and long term goals. Treatment sessions were initially given twice daily, then once weekly and later once monthly, as the patient gained control, confidence and independence. After 68 sessions of treatment spanning almost 2 years, the patient had gained independent walking, improved quality of life, and in particular titubation disappeared.

Prophylaxis of occipital pressure sores in patients after elective spinal surgery in a pandemic condition.

BackgroundOccipital pressure sores (OPS) are complications of the use of cervical collars. Prophylaxis of OPS in patients after cervical spinal surgery (CCS) appears to be neglected.Material and methodsCochrane Central, EMBASE, PubMed, SCOPUS, and Web of Science databases were searched for studies on OPS after CCS.ResultsWe present the case of a patient with rheumatic arthritis who was secured with a hard collar after revision CCS and was not seen by a health professional due to the COVID-19 outbreak. The result was an OPS leading to deep tissue infection. The patient required a prolonged hospital stay and long-term antibiotic therapy. We found a lack of literature on OPS prevention in patients after CCS.ConclusionsPatients with rheumatoid arthritis using collars after CCS are at risk of OPS. Protocols of prevention of OPS should be reviewed with respect to challenges resulting from epidemiological restrictions and accessibility of telemedical technologies.

Decreased Arm Movement in Non-Verbal Male

A 13-year-old non-verbal Trisomy 21 male presents to the emergency department with decreased arm movement four days after witnessed ground level fall. Patient intermittently using arm normally, ambulating, and neurologically at baseline. Arm imaging negative for fracture or dislocation. Review of past medical history reveals prior use of cervical collar for resolved subluxation. Cervical spine imaging reveals complete anterior dislocation of C1 on C2.

Neurosurgeons Relate Heterogeneous Practices Regarding Activity and Return to Work After Spine Surgery

Given the paucity of relevant data, the Council of State Neurosurgical Societies Workforce Committee launched a survey of neurosurgeons to assess patterns in activity restriction recommendations following spine surgery; the ultimate goal was to optimize and potentially standardize these recommendations. The aim of this initial study was to determine current practices in activity restrictions and return to work guidelines following common spinal procedures. The survey included questions regarding general demographics and practice data, postoperative bracing/orthosis utilization, and guidelines for postoperative return to different levels of activity/types of work following specific spine surgery interventions. A spectrum of typical spine surgeries was assessed, including microdiscectomy, anterior cervical discectomy and fusion (ACDF), and lumbar fusion, both open and minimal invasive surgery (MIS) approaches. There was significant interprocedure and intraprocedure variation in the neurosurgeons' recommendations for postoperative activity and return to work recommendations after various spinal surgery procedures. Comparisons of the different surgical procedures evaluated revealed significant differences in cervical collar use (more often used following ≥2-level ACDF than single-level ACDF; P < 0.001), return to both sedentary and light physical work (greater restriction with ≥2-level ACDF than with single-level ACDF; P < 0.001), and return to a light exercise regimen (sooner following MIS versus open lumbar fusion; P < 0.001). This survey demonstrated little consistency regarding return to work recommendations, general activity restrictions, and orthosis utilization following common spinal surgical procedures. Addressing this issue also has significant implications for the societal and personal costs of spine surgery.

The Difference Effect of Special Cervical Collar with Height of 5 cm and 6 cm to Reduce Neck Pain among Students in Karanganyar, Central Java

Background: Specific cervical collars need to be standardized in order to effectively and efficiently reduce cervical syndrome pain. This condition occurs because the radicle vertebrae are compressed in the long term and even pain can radiate to both shoulders and even to the arches of both hands, this condition will result in abnormal and rapid fatigue. The purpose of this study was to find a standardized cervical collar design specifically to reduce cervical syndrome pain in Tahfidz Karanganyar Islamic boarding school students. Subjects and Method: This was a Randomized Control Trial (RCT) study which was con-ducted from March 2022 to August 2022 in all Tahfidz Islamic boarding schools in Karang-anyar, Central Java, Indonesia. The sample in this study were 160 students with cervical syndrome. Each group in this study consisted of 80 students who were divided into control and treatment groups using simple random sampling. The dependent variable in this study is neck pain (cervical syndrome). The independent variable is the use of the cervical collar. Data analysis uses the Independent samples t-test if the data is normal, and uses the Mann Whitney test if the data is not normal. Results: After the intervention was given, the results showed that the average pain in the intervention group using a special collar as high as 6 cm (Mean = 1.11; SD = 0.39) was lower in pain compared to the control group using a special collar as high as 5 cm (Mean = 3.50; SD = 0.57) and statistically significant (p&lt;0.001). Conclusion: The use of a special cervical collar with a height of 6 cm is more effective in reducing pain than a special cervical collar with a height of 5 cm. Keywords: cervical syndrome, cervical collar, special cervical collar with a height of 6 cm and 5 cm. Correspondence: Alfan Zubaidi. Department of Orthotic Prosthetic, Ministry of Health Surakarta. Jl. Letjen Sutoyo, Mojosongo, Surakarta, Central Java, Indonesia. Email :drsalfanzubaidi@gmail.com. Indonesian Journal of Medicine (2022), 07(04): 411-416 https://doi.org/10.26911/theijmed.2022.07.04.06

Comparative Efficacy Analysis of Intubation Profile in Airtraq Video Laryngoscope Versus Macintosh Laryngoscope in Simulated Difficult Airway Using Cervical Collar

Aim: Comparative efficacy analysis of laryngoscopes -Airtraq vs macintosh - using Intubation Time and Intubationdifficulty score in simulated difficult airway using cervical collar.Methods: Peculiarity is simulated difficult airway by use of cervical collar. A prospective interventionalrandomizedstudy conducted on 60 adult ASA grade-I&amp;II patients scheduled for surgery in tertiary care center.Tracheal Intubation 1. Group(AVL) Airtraq videolaryngoscope (n=30) 2. Group(ML) Macintoshlaryngoscope(n=30). Parameters observed: 1) Intubation Time- seconds 2) Intubation Difficulty Score (IDS) comprised Numbersof-1. intubation attempts 2.operators 3.alternative intubation techniques, 4. Glottic exposure. 5. paramatriccomparison lifting force required during laryngoscopy, Necessity for external laryngeal pressure, Position of thevocal cords.Results: With airtraq laryngoscope intubation discoursed outcomes intubation time is irrelevant with difficultairway where it is highly associated in case of macintosh laryngoscope. Intubation time &amp; difficulty score iscommentating use of Airtraq laryngoscope.Conclusions: The enhanced visual interiors expedite in such a way that intubation time in Airtraq is not dependenton IDS like Macintosh but on neuromuscular reflexes of performer, commentating the superiority of Airtraq overMacintosh

Use of Soft Cervical Collar among Whiplash Patients in Two Italian Emergency Departments Is Associated with Persistence of Symptoms: A Propensity Score Matching Analysis.

Purpose: Although the use of soft cervical collars in the emergency department (ED), for whiplash-associated disorders (WAD), is controversial, it is still widely adopted. The purpose of our study was to investigate the impact of the early use of soft cervical collars on the return to the ED, within three months of a road traffic collision. Methods: We conducted a retrospective observational study on WAD patients from two EDs in Verona (Italy). Patients in the earlier acute phase of WAD (within 48 h from the trauma) were included; those with serious conditions (WAD IV) were excluded. As an end point, we considered patients who returned to the ED complaining of WAD symptoms within three months as positive outcome for WAD persistence. Results: 2162 patients were included; of those, 85.4% (n = 1847/2162) received a soft cervical collar prescription. Further, 8.4% (n = 156/1847) of those with a soft cervical collar prescription, and 2.5% (n = 8/315) of those without a soft cervical collar (p < 0.001) returned to the ED within three months. The use of the soft cervical collar was an independent risk factor for ED return within three months, with an OR, adjusted for possible clinical confounders, equal to 3.418 (95% CI 1.653–7.069; p < 0.001). After the propensity score matching, 25.5% of the patients (n = 25/98) using the soft cervical collar returned to the ED at three months, compared to the 6.1% (n = 6/98) that did not adopt the soft cervical collar. The use of a soft cervical collar was associated with ED return with an OR = 4.314 (95% CI 2.066–11.668; p = 0.001). Conclusions: Our study shows that the positioning of the soft collar in a cohort of patients with acute WAD, following a rear-end car collision, is an independent potential risk factor to the return to the ED. Clinically, the use of the collar is a non-recommended practice and seems to be related to an increased risk of delayed recovery. There is a need to inform healthcare providers involved in the ED of the aim to limit the use of the soft cervical collar. A closer collaboration between clinicians (e.g., physicians, physical therapists, nurses) is suggested in the ED. Future primary studies should determine differences between having used or not having used the collar, and compare early physical therapy in the ED compared with the utilization of the collar.

The Effect of the Use of Cervical Collar on the Reduction of Neck Pain: Meta-Analysis

Background: Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Nearly 50% of individuals will continue to experience pain or it often occurs to some degree. This study aimed to analyze the magnitude of the effect of using a cervical collar on reducing the degree of pain in neck pain patients compared to manual therapy (exercises). Subjects and Method: This research is a systematic review and meta-analysis carried out by following the PRISM diagram flow. The process of searching for articles through a journal database that includes: PubMed, Google Scholar and Science Direct by selecting articles published in 2000-2020. The keywords used include: “cervical collar” OR “neck collar” OR “soft collar” OR “hard collar” AND “neck pain” AND “cervical pain” AND “cervical radiculopathy” AND “cervical syndrome” AND “randomized controlled trial”. The inclusion criteria were full paper articles with a randomized controlled trial study design, articles using English and Indo­nesian, and bivariate analysis with adjusted odds ratio. Articles that meet the require­ments are analyzed using the Revman 5.3 application. Results: A total of 6 articles were reviewed in this study with a randomized controlled trial study design. Meta-analysis of 6 randomized controlled trial (RCT) studies showed that there was no difference in effectiveness in using cervical collars compared to manual therapy (exercises) in reducing neck pain (ES = 0.04; 95% CI -0.31 to 0.39; p = 0.083). Conclusion: This meta-analysis concluded that there was no difference in effectiveness between the use of cervical collars and manual therapy (exercises) in reducing the degree of pain in neck pain. Keyword s : neck pain, cervical collar, exercises,meta-analisis Correspondence: Hisyam Syafi’ie. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: bunghifi@gmail.com. Mobile: 081326­002006. Indonesian Journal of Medicine (2021), 06(01): 112-118 https://doi.org/10.26911/theijmed.2021.06.01.12

Neurologic outcomes following the introduction of a policy for using soft cervical collars in suspected traumatic cervical spine injury: A retrospective chart review.

In trauma patients with potential cervical spine injury, immobilisation with a rigid cervical collar is widely recommended to prevent a secondary spinal cord injury. There is a lack of evidence for the effectiveness of this practice, but increasing evidence for complications from rigid collars. Soft foam collars may mitigate some of these issues and are used in our health service in place of rigid collars in selected patients at risk for traumatic cervical spine injury. The objective of the present study was to describe the neurological outcome of patients according to the cervical stabilisation technique used. A multi-centre, retrospective, consecutive, case series of all patients assessed for a traumatic cervical spine injury from October 2017 to July 2018 was conducted. Data were obtained by a medical chart review. The primary outcome was the development of a new neurological deficit because of spinal cord injury while in hospital. Inter-rater reliability of data abstraction demonstrated very strong agreement (kappa 0.85, 95% confidence interval 0.80-0.90). Of 2036 patients, 1133 were managed in a soft collar. A new neurological deficit because of spinal cord injury developed in two patients managed in a rigid collar. One case managed in a soft collar was uncertain because of an incomplete baseline neurological examination. The use of soft foam cervical collars in patients at risk for a cervical spine injury does not appear to increase the risk for secondary spinal cord injury but larger prospective studies are required before a robust conclusion on safety can be claimed.

Effect of 5 different cervical collars on optic nerve sheath diameter

Utilizing cervical collars is a common practice in emergency departments. Multiple studies have been conducted on the utility of this practice, but few have looked into the negative effects of cervical collar (C-collar) use. The authors of this study were concerned that cervical collars could be leading to varying degrees of venous compression. Venous compression leads to increased intracranial pressure (ICP) due to improper vascular drainage. Further, numerous studies in the literature have shown that an elevated ICP is associated with mortality and poor neurologic outcomes.