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Evaluating prehospital care of patients with potential traumatic spinal cord injury: scoping review

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Abstract

Purpose

To gain insight into current research regarding prehospital care (PHC) in patients with potential traumatic spinal cord injury (TSCI) and to disseminate the findings to the research community.

Methods

In March 2019, we performed a literature search of publications from January 1990 to March 2019 indexed in PubMed, gray literature including professional websites; and reference sections of selected articles for other relevant literature. This review was performed according to Arksey and O’Malley’s framework.

Results

There were 42 studies selected based on the inclusion criteria for review; 18 articles regarding immobilization; 12 articles regarding movement, positioning and transport; four for spinal clearance; three for airway protection; and two for the role of PHC providers. There were some articles that covered two topics: one article was regarding movement, positioning and transport and airway protection, and two were regarding spinal clearance and the role of PHC providers.

Conclusion

There was no uniform opinion about spinal immobilization of patients with suspected TSCI. The novel lateral trauma position and one of two High Arm IN Endangered Spine (HAINES) methods are preferred methods for unconscious patients. Controlled self-extrication for patients with stable hemodynamic status is recommended. Early and proper identifying of potential TSCI by PHC providers can significantly improve patients’ outcomes and can result in avoiding unwanted spinal immobilization. Future prospective studies with a large sample size in real-life settings are needed to provide clear and evidence-based data in PHC of patients with suspected TSCI.

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Availability of data and material (data transparency)

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Funding

This work was funded by Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences (TUMS). Grant number is 98-01-38-41212.

Author information

Authors and Affiliations

  1. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Roya Habibi Arejan, Mohammad Hossein Asgardoon, Maryam Shabany, Zahra Ghodsi, Masoud Sohrabi Asl & Vafa Rahimi-Movaghar

  2. Rehabilitation Office, State Welfare Organization of Iran, Tehran, Iran

    Roya Habibi Arejan

  3. Iranian Student Society for Immunodeficiencies, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Hossein Asgardoon

  4. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Shabany & Vafa Rahimi-Movaghar

  5. Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Hamid Reza Dehghan

  6. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Hamidreza Ostadrahimi

  7. Department of Orthopedics and Neurosurgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA

    Alex R. Vaccaro

  8. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Vafa Rahimi-Movaghar

  9. Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Vafa Rahimi-Movaghar

  10. Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran

    Vafa Rahimi-Movaghar

  11. Spine Program, University of Toronto, Toronto, ON, Canada

    Vafa Rahimi-Movaghar

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  1. Roya Habibi Arejan
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Correspondence to Vafa Rahimi-Movaghar.

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Conflict of interest

We announce that the authors do not have any conflict of interest regarding this research except Alexander R. Vaccaro. Alexander R. Vaccaro has the following conflicts of interest: Royalties: Aesculap; Atlas Spine; Globus; Medtronics; SpineWave; Stryker Spine; Elsevier; Jaypee; Taylor Francis/Hodder and Stoughton; Thieme. Stock options: Advanced Spinal Intellectual Properties; Atlas Spine; Avaz Surgical; Bonovo Orthopaedics; Computational Biodynamics; Cytonics; Deep Health; Dimension Orthotics LLC; Electrocore; Flagship Surgical; FlowPharma; Globus; Innovative Surgical Design; Insight Therapeutics; Jushi; Nuvasive; Orthobullets; Paradigm Spine; Parvizi Surgical Innovation; Progressive Spinal Technologies; Replication Medica; Spine Medica; Spinology; Stout Medical; Vertiflex; ViewFi Health.

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Habibi Arejan, R., Asgardoon, M.H., Shabany, M. et al. Evaluating prehospital care of patients with potential traumatic spinal cord injury: scoping review. Eur Spine J 31, 1309–1329 (2022). https://doi.org/10.1007/s00586-022-07164-4

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