Table 3.

Summary of conclusions. Should spinal collars be used?

Study	Yes	No	Undecided	Notes
Underbrink et al. [21]			X	No differences in neurologic deficit
Oosterwold et al. [19]			X	Adverse effects of spinal immobilisation were incompletely documented
Vanderlan et al. [22]		X		Increased risk of death
Haut et al. [16]		X		Higher mortality in penetrating trauma and should not be used in every trauma patient
Brown et al. [14]			X	Unproven risk
Hauswalk et al. [15]		X		Immobilisation has little or no effect on neurologic outcome and can be deemed unnecessary
Lemyze et al. [17]		X		When a patient has hung a spinal collar can increase the intracerebral pressure, so not to use them at all or if they have been used them remove them as soon as possible
Lin et al. [18]		X		It needs to be revised to avoid unnecessary restraint and possible complications
Barkana et al. [13]		X		If spinal collars are using for penetrating injuries of the neck this may mean neck injuries are overlooked and covered by a device and new management guidelines concerning pre-hospital stabilisation are suggested