The Impact of Prehospital Spinal Immobilization in Patients with Penetrating Spinal Injuries: A Systematic Review and Meta-Analysis
Trauma Care · 2022-04-26 · Meta-analysis
Abstract
Penetrating injuries, such as gunshot or stab wounds, may cause spinal cord injuries and require prehospital spinal immobilization (PHSI) to stabilize the spine. However, the use of PHSI in penetrating spinal injuries remains controversial. This systematic review aimed to investigate the efficacy of prehospital PHSI in patients with penetrating trauma. We systematically searched Google Scholar, Medline (PubMed), The Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE between January 2000 and July 2021. All studies in English that assessed PHSI in patients (>16 years) with penetrating spinal injuries were included. Quality and risk of bias assessments were performed using the modified Newcastle-Ottawa scale. A narrative synthesis and a meta-analysis was conducted. Our search identified 928 studies but only 6 met our inclusion and exclusion criteria. All of the included studies were conducted in the US and the number of patients ranged from 156–75,567 over 3–9 study years. The majority of patients were gunshot or stab wounds. Three studies demonstrated an increased risk of mortality with spinal collars whilst the remaining three studies failed to show any benefits or the benefits remained unproven. All studies were retrospective studies with some risks of bias. This review highlights that the evidence from the literature on PHSI in penetrating trauma outweigh its benefits; thus, its use is discouraged in penetrating spinal trauma. However, further high-quality research is necessary to reach definitive conclusions and to possibly identify suitable alternatives to PHSI for penetrating spinal trauma.
Abstract © the authors or publisher, via OpenAlex. Reuse and removal
Tags
Spinal motion restriction · Mortality & survival
Related articles
- Cervical spine immobilization may be of value following firearm injury to the head and neck. (Am J Emerg Med, 2016)
- Spine immobilization in penetrating trauma: more harm than good? (J Trauma, 2010)
- Thoracolumbar immobilization for trauma patients with torso gunshot wounds: is it necessary? (Arch Surg, 2001)
- Cervical Spine Injury is Rare in Self-Inflicted Craniofacial Gunshot Wounds: An Institutional Review and Comparison to the US National Trauma Data Bank (NTDB). (Prehosp Disaster Med, 2020)
- Effect of prehospital cervical spine immobilization on mortality and neurological outcome in trauma patients: an observational cohort study with propensity score matching based on the trauma registry of the German trauma society (TraumaRegister DGU®). (World J Emerg Surg, 2026)
- A Ten-Year Retrospective Cohort Study on Neck Collar Immobilization in Trauma Patients with Head and Neck Injuries. (Medicina (Kaunas), 2023)