Motion in the Unstable Cervical Spine During Hospital Bed Transfers

Abstract

Hospital bed transfers, moves to examination room, X-ray, hospital bed, and/or surgery, have the potential of causing harm to a patient with an unstable cervical spine. This study evaluated motion generated in an unstable segment of the cervical spine during hospital bed transfers. A secondary goal purpose was to assess reduction in cervical motion using three collars and a no collar condition. Cervical spine instability was created at C5-C6 in cadavers. A repeated measures design was used to compare bed transfer techniques: manual transfer performed by six trained individuals and a transfer made by two people using the On3 lateral transfer device. Both techniques were tested under four collar conditions. Cervical spine motion was measured using an electromagnetic motion analysis device with sensors fixed to the anterior bodies of C5 and C6. No significant differences were observed between transfer techniques (flexion, [p = 0.325]; axial rotation [p = 0.590]; lateral bending [p = 0.112]). Nor were there significant differences among the three collars used (flexion [p = 0.462]; axial rotation [p = 0.434]; lateral bending [p = 0.250]). For all transfers, using no collar resulted in more motion than using a collar; but was not statistically significant. Bed transfers made with a lateral transfer device seem to be as safe as those made by the lift and slide manual transfer. None of the collars tested were significantly better at preventing cervical spine motion during a transfer, but each allowed less movement than no collar.