How effective is the Newport/Aspen collar? A prospective radiographic evaluation in healthy adult volunteers

Background: Cervical extrication collars are used in the evacuation of the injured to minimize secondary injury. These collars were designed for extrication and evacuation, not for longterm use, and complications have been reported when they have been used in the rehabilitation phase. The Newport/Aspen collar was designed specifically for long-term use.

Methods: Using a radiographic method, the effectiveness of the collar in restricting motion was evaluated for the cervical spine as a whole and for constituent segments, occiput to C7, in 15 normal volunteers.

Results: Combined flexion-extension was reduced from mean 98.8 to 31.1 degrees (31.5% of normal; p = 0.000000002), lateral bending was reduced from mean 31.1 to 15.9 degrees (51.1% of normal; p = 0,0000001), and overhead rotation was reduced from mean 64.6 to 26.8 degrees (41% of normal; p 0,000000002), The cervical spine, however, does not move as one unit; paradoxical motion, the phenomenon of "snaking," occurs. Goniometric techniques do not demonstrate this effect. Data are provided for motion by segmental level.

Conclusion: Full cervical immobilization is a myth. It would seem logical to match the level-specific efficacy of the device to the level of injury. Data are provided for the Aspen collar.