Comparison of the Nebraska Collar, a New Prototype Cervical Immobilization Collar, With Three Standard Models

OBJECTIVES: To determine whether a novel immobilization collar called the Nebraska collar would restrict motion of the cervical spine better than three traditional designs: the Philadelphia collar, the sterno occipital mandibular immobilizer (S.O.M.I.), and the Lehrman-Minerva cervical orthosis. DESIGN: Cervical spine radiographs and a compass were used to assess motion allowed by four separate cervical collars placed on volunteers. SETTING: University-affiliated level one trauma center. PATIENTS/PARTICIPANTS: Fourteen paid volunteers (six females and eight males) between the ages of twenty and thirty-five years (mean twenty-five years) were recruited. MAIN OUTCOME MEASUREMENTS: The maximum amount of flexion, extension, and lateral bending permitted by each collar was assessed by cervical radiographs taken of the volunteers while wearing each of the four collars. Maximum rotation was measured with a compass positioned on the top of the head of the volunteers and oriented in the horizontal plane. RESULTS: The Nebraska collar restricted rotation (p < 0.0001) and lateral bending (p < 0.0001) significantly more than did the other three orthoses. In total maximum extension from occiput to C7, the Nebraska collar was found to be more restrictive than the Philadelphia collar (p < 0.05) and the S.O.M.I. (p < 0.05). In total maximum flexion, there was no statistically significant difference among the four collars. When the total maximum flexion-to-extension motion was measured, both the Nebraska and Lehrman-Minerva cervical collars were found to be more restrictive than the Philadelphia collar (p < 0.05). CONCLUSION: The new Nebraska collar provides stabilization that is significantly more rigid than the other models tested, with no difference in patient comfort.