A side view of a person wearing a C spine collar.
A cervical collar, also known as a neck brace, is a medical device used to support a person's neck. It is also applied by emergency personnel to those who have had traumatic head or neck injuries, and can be used to treat chronic medical conditions.
Whenever people have a traumatic head or neck injury, they may have a cervical fracture. This makes them at high risk for spinal cord injury, which could be exacerbated by movement of the person and could lead to paralysis or death. A common scenario for this injury would be a person suspected of having whiplash because of a car accident. In order to prevent further injury, such people may have a collar placed by medical professionals until X-rays can be taken to determine if a cervical spine fracture exists. The cervical collar only stabilizes the top seven vertebrae, C1 through C7. (Other immobilizing devices such as a Kendrick Extrication Device or a backboard can be used to stabilize the remainder of the spinal column.)
The routine use of a cervical collar by a first aid provider is not recommended.
Cervical collars are also used therapeutically to help realign the spinal cord and relieve pain, although they are usually not worn for long periods of time. Another use of the cervical collar is for strains, sprains or whiplash. If pain is persistent, the collar might be required to remain attached to help in the healing process. A person may also need a cervical collar, or may require a halo fixation device to support the neck during recovery after surgery such as cervical spinal fusion.
A soft collar is fairly flexible and is the least limiting but can carry a high risk of further breakage, especially in people with osteoporosis. It can be used for minor injuries or after healing has allowed the neck to become more stable.
A range of manufactured rigid collars are also used, usually comprising (a) a firm plastic bi-valved shell secured with Velcro straps and (b) removable padded liners. The most frequently prescribed are the Aspen, Malibu, Miami J, and Philadelphia collars. All these can be used with additional chest and head extension pieces to increase stability.
Cervical collars are incorporated into rigid braces that constrain the head and chest together. Examples include the Sterno-Occipital Mandibular Immobilization Device (SOMI), Lerman Minerva and Yale types. Special cases, such as very young children or non-cooperative adults, are sometimes still immobilized in medical plaster of paris casts, such as the Minerva cast.
Use Over Time
As a result of several randomized clinical trials over the last decade, hospitals and ambulance staff have seen a significant reduction in the number of patients that are being immobilized. This has been due to complications such as increased intracranial pressure with traumatic brain injury, along with access issues for airway management in obtunded patients. Some medical professionals have even been calling for a ban of Cervical Collars, stating that they cause more harm than good. There is also very little evidence that shows Cervical Collars to be actually making a difference in traumatic cervical spine injury.
Designs range from simple foam collars to complex composite devices.
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