Effects of prehospital spinal immobilization: a systematic review of randomized trials on healthy subjects

Objective: To evaluate the effects of spinal immobilization on healthy participants. Methods: A systematic review of randomized, controlled trials of spinal immobilization on healthy participants. Results: Seventeen randomized, controlled trials compared different types of immobilization devices, including collars, backboards, splints, and body strapping. For immobilization efficacy, collars, spine boards, vacuum splints, and abdominal/torso strapping provided a significant reduction in spinal movement. Adverse effects of spinal immobilization included a significant increase in respiratory effort, skin ischemia, pain, and discomfort. Conclusions: Data from this review provide the best available evidence to support the well-recognized efficacy and potential adverse effects of spinal immobilization. However, comparisons of different immobilization strategies on trauma victims must be considered in order to establish an evidence base for this practice.