Table 2. Summary of neurological and spinal injury outcomes in patients with suspected traumatic cervical spine injury.
a) Neurological deterioration. b) Spinal/neurological injury.
| Author, year | Outcomes | Definition | Findings | ||
|---|---|---|---|---|---|
| Intervention (n/N) | Control (n/N) | Effect estimate (author calculated) | |||
| Thompson et al. [Unpublished] | Neurological deterioration | New neurology was assessed on clinical examination where there was any compromise to sensory, motor or reflex function or presence of neurogenic shock. This followed the criteria highlighted by the International Standards for Classification of Spinal Cord Injury [30] |
Full immobilisation: 0/30 (0%) |
Movement minimisation: 0/26 (0%) | OR: not estimable |
| Asha et al. 2021 [25] | Neurologic deficit present on arrival to ED |
NR | Movement minimisation–Combined: 92/1401 (6.6%) a | No immobilisation: 21/582 (3.6%) |
OR: 1.88 (95% CI: 1.16, 3.05; p = 0.01) |
| New neurologic deficit during hospital stay |
The development of neurological deficit during the hospital admission was determined from the discharge summary but included none organic cause (all imaging normal and neurologic deficit resolved while in hospital), progression of intracranial injuries, and spinal cord injury |
Movement minimisation–Combined: 9/1401 (0.6%) b | No immobilisation: 0/582 (0%) |
OR: 7.95 (95% CI: 0.46, 136.78; p = 0.15) |
|
Abbreviations: ED, emergency department; NR, not reported; OR, odds ratio.
a Movement minimisation—Rigid collar group: 29/268 (10.8%); Movement minimisation—Soft collar group: 63/1133 (5.6%).
b Movement minimisation—Rigid collar group: 3/268 (1.1%); Movement minimisation—Soft collar group: 6/1133 (0.5%). Of the 9 with neurological deterioration 3 had no organic cause and resolved during admission, 3 were due to progression of brain injury and 2 attributable to spinal cord injury and one of uncertain aetiology.
Abbreviations: ICD-9, International Classification of Diseases 9th revision; NR, not reported; OR, odds ratio.
a Movement minimisation—Rigid collar group: 17/268 (6.3%); Movement minimisation—Soft collar group: 77/1133 (6.8%).
b Additional information reported in paper–no significant correlation observed when comparing cervical spine injury patients with movement minimisation and no immobilisation (χ2, p = 0.896).
c Information reported in paper—adjusted (for age, sex, level of injury, and mechanism of injury) OR: 2.03; 95% CI: 1.03, 3.99; p = 0.04.
d Information reported in paper—adjusted (for age, sex, level of injury, and mechanism of injury) OR: 1.52; 95% CI 0.64, 3.62; p = 0.34.