Spinal immobilization on a flat backboard: does it result in neutral position of the cervical spine?

Abstract

To determine the amount of occipital padding required to achieve neutral position of the cervical spine when a patient is immobilized on a flat backboard. Neutral position was defined as the normal anatomic position of the head and torso that one assumes when standing looking straight ahead. Descriptive with hypothesis testing of selected descriptive elements. University campus and hospital. One hundred healthy young adults with no history of back disease. Volunteers were measured in standing and supine positions. Occipital offset; height; weight; and head, neck, and chest circumferences were measured for each subject. The amount of occipital offset required to achieve neutral position varied from 0 to 3.75 in. (mean, 1.5 in.). Mean occipital offset for men (1.67 in.) was significantly greater than that for women (1.31 in.) Easily obtained body measurements did not accurately predict occipital offset. Immobilization on a flat backboard would place 98% of our study subjects in relative cervical extension. Occipital padding would place a greater percentage of patients in neutral position and increase patient comfort during transport.