Download PDF
Evid Based Spine Care J 2013; 04(02): 072-077
DOI: 10.1055/s-0033-1357353
Original Research
Georg Thieme Verlag KG Stuttgart · New York

A Validated Classification for External Immobilization of the Cervical Spine

Micha Holla
1   Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
,
Joske M. R. Huisman
1   Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
,
Allard J. F. Hosman
1   Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
› Author Affiliations
Further Information

Publication History

21 January 2013

18 July 2013

Publication Date:
21 November 2013 (online)

   Permissions and Reprints

Abstract

Study Design Interobserver and intraobserver reliability study.

Objective The aim of this study is to validate a new classification system of external cervical spine immobilization devices by measuring the interobserver and intraobserver agreement.

Methods A classification system, with five main categories, based on the anatomical regions on which the device supports, was created. A total of 28 independent observers classified 50 photographs of different devices, designed to immobilize the cervical spine according to the new proposed classification system. At least 2 weeks later, the same devices were classified again in a new random order. Before and after the classification, all the participants answered questions about the usefulness of the proposed classification.

Results The mean interobserver and intraobserver agreement Fleiss' kappa was 0.88 and 0.91, respectively. Both are, according to the interpretation described by Landis and Koch, “almost perfect.” A majority of the participators answered that they needed a classification (89%) and considered the classification to be clear (96%). All the participants considered the classification to be useful in clinical practice.

Conclusion This study showed that the new classification of external cervical spine immobilizers, based on anatomical support areas, has an excellent interobserver and intraobserver agreement. Furthermore, the study participants considered the proposed classification to be clear and useful in clinical practice. As the majority of patients with cervical spine injuries are treated with external immobilization devices, this new classification system can improve the closed treatment of cervical spine injuries in daily clinical practice. Furthermore, it makes reproducible comparisons between groups possible, which are essential for further evolution of evidence-based spine care.

Keywords

classification - external - cervical - collars - immobilizers

Supplementary Material

 

  • References

  • 1 Fredø HL, Rizvi SAM, Lied B, Rønning P, Helseth E. The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. Scand J Trauma Resusc Emerg Med 2012; 20: 85-85
    CrossrefPubMedGoogle Scholar
  • 2 Agabegi SS, Asghar FA, Herkowitz HN. Spinal orthoses. J Am Acad Orthop Surg 2010; 18 (11) 657-667
    PubMedGoogle Scholar
  • 3 Urbaniak GC, Plous S. Research Randomizer Form v4.0 2011. http://www.randomizer.org . Accessed March 2, 2011
    PubMedGoogle Scholar
  • 4 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 (1) 159-174
    CrossrefPubMedGoogle Scholar