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A Change from a Spinal Immobilization to a Spinal Motion Restriction Protocol was Not Associated with an Increase in Disabling Spinal Cord Injuries

Published online by Cambridge University Press:  03 November 2021

Brian M. Clemency Open the ORCID record for Brian M. Clemency [Opens in a new window] ,
Peter Natalzia Open the ORCID record for Peter Natalzia [Opens in a new window] ,
Johanna Innes ,
Sharon Guarino ,
Jacob V. Welch ,
Arsalan Haghdel ,
Ekaterina Noyes ,
Jeffery Jordan ,
Heather A. Lindstrom Open the ORCID record for Heather A. Lindstrom [Opens in a new window]  and
E. Brooke Lerner
Brian M. Clemency*
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Peter Natalzia
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Johanna Innes
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Sharon Guarino
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Jacob V. Welch
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Arsalan Haghdel
Affiliation:
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New YorkUSA
Ekaterina Noyes
Affiliation:
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New YorkUSA
Jeffery Jordan
Affiliation:
Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
Heather A. Lindstrom
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
E. Brooke Lerner
Affiliation:
Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New YorkUSA
*
Correspondence: Brian M. Clemency, DO, MBA, FACEP, FAEMS Department of Emergency Medicine Jacobs School of Medicine and Biomedical Sciences University at Buffalo 462 Grider St. Buffalo, New York14075USA E-mail: bc34@buffalo.edu
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Abstract

Background:

Over the past decade, Emergency Medical Service (EMS) systems decreased backboard use as they transition from spinal immobilization (SI) protocols to spinal motion restriction (SMR) protocols. Since this change, no study has examined its effect on the neurologic outcomes of patients with spine injuries.

Objectives:

The object of this study is to determine if a state-wide protocol change from an SI to an SMR protocol had an effect on the incidence of disabling spinal cord injuries.

Methods:

This was a retrospective review of patients in a single Level I trauma center before and after a change in spinal injury protocols. A two-step review of the record was used to classify spinal cord injuries as disabling or not disabling. A binary logistic regression was used to determine the effects of protocol, gender, age, level of injury, and mechanism of injury (MOI) on the incidence of significant disability from a spinal cord injury.

Results:

A total of 549 patients in the SI period and 623 patients in the SMR period were included in the analysis. In the logistic regression, the change from an SI protocol to an SMR protocol did not demonstrate a significant effect on the incidence of disabling spinal injuries (OR: 0.78; 95% CI, 0.44 - 1.36).

Conclusion:

This study did not demonstrate an increase in disabling spinal cord injuries after a shift from an SI protocol to an SMR protocol. This finding, in addition to existing literature, supports the introduction of SMR protocols and the decreased use of the backboard.

Keywords

backboardsignificant disabilityspinal immobilizationspinal motion restrictionspine injury
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 6 , December 2021 , pp. 708 - 712
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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