救护车运送过程中颈椎和胸腰椎的生物力学运动分析:一项健康志愿者研究

D. Wampler, Ronald M Stewart, R. Summers, R. Schaefer, L. Roakes, Craig Cooley, Mike Shown, T. Long, Chetan U. Kharod, B. Eastridge
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引用次数: 1

摘要

背景:最近的证据表明,长脊柱板(LSB)可能对控制脊柱运动没有什么作用,而且会增加风险。该项目旨在测量救护车运输过程中颈椎和胸腰椎的运动。假设是在床垫上运输,头部抬高,没有LSB,会比在LSB上运输允许更少的脊柱运动。方法:一项随机健康志愿者交叉试验,使用生物传感器测量脊柱运动。分析的位置包括LSB上的0°和10°。单独担架,头部升高到10°,30°,45°和60°,带和不带头部块。模拟救护车在城市街道上以或低于限速行驶。结果:纳入9名受试者,其中66%为男性。对于颈椎运动,轴向、屈伸或旋转均无差异(分别为0.2±0.1 mm vs. 0.2±0.1 mm, 24±12 mm vs. 22±10 mm, 5.1±19°vs. 5.8±20°)。侧移(3.7±7 mm LSB vs. 2.0±5 mm无LSB)和头部体积运动(120±172 mm 3 LSB vs. 77±86 mm 3无LSB)差异有统计学意义。允许最低平均头部运动颈椎容积的体位被抬高至30°和45°,并放置头块(分别为20±22 mm 3和12±6 mm 3)。在胸腰椎运动方面,胸腰椎三维体积运动无统计学差异(2±0.6 mm 3 LSB vs. 4.7±5 mm 3无LSB)。结论:两组患者脊柱运动均较小。没有LSB的担架床垫比LSB允许更少的颈椎运动。被固定在担架床垫上且床头抬高至30°的受试者脊柱运动最少。中华神经科学杂志,2020;10(3):73-79 doi: https://doi.org/10.14740/jnr587
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Biomechanical Motion Analysis of Cervical and Thoracolumbar Spine During Ambulance Transport: A Healthy Volunteer Study
Background: Recent evidence suggests that long spine board (LSB) may do little to manage spinal motion, and pose increased risk. This project sought to measure cervical and thoracolumbar motion during ambulance transport. The hypothesis was transport on a mattress with the head elevated without the LSB would allow less spinal movement than transport on an LSB. Methods: A randomized healthy volunteer crossover trial measured spinal motion using biometric sensors. Positions analyzed included 0 and 10° on LSB. Stretcher alone with head elevated to 10°, 30°, 45° and 60°, with and without head blocks. Simulated ambulance transport was on city streets at or below posted speed limits. Results: Nine subjects were included, with 66% being male. For cervical movement, there was no difference in axial, flexion/extension, or rotation (0.2 ± 0.1 mm vs. 0.2 ± 0.1 mm, 24 ± 12 mm vs. 22 ± 10 mm, and 5.1 ± 19° vs. 5.8 ± 20°, respectively). There were significant differences in lateral (3.7 ± 7 mm LSB vs. 2.0 ± 5 mm no LSB) movement and volumetric movement of the head (120 ± 172 mm 3 LSB vs. 77 ± 86 mm 3 no LSB). Positions allowing the lowest mean cervical volume of head movement were bed elevated to 30° and 45° with head blocks, (20 ± 22 mm 3 and 12 ± 6 mm 3 , respectively). For thoracolumbar movement, there was no statistical difference in three-dimensional volumetric movement of the thoracolumbar spine (2 ± 0.6 mm 3 LSB vs. 4.7 ± 5 mm 3 no LSB). Conclusion: Spinal motion was small in all groups. The stretcher mattress without LSB allowed less cervical motion than the LSB. Subjects secured to a stretcher mattress with head of the bed elevated to 30° had the least spinal movement. J Neurol Res. 2020;10(3):73-79 doi: https://doi.org/10.14740/jnr587
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