Is the immobilization of a traumatized patient still the best practice? A literature review

Cervical spine immobilization methods were adopted worldwide and were not questioned until the 2000s. From the 1970s to the 1980s, the incidence and mortality of spinal injuries decreased significantly, and as this coincided with the introduction of modern spinal management strategies, several experts credited spinal stabilization with this reduction. As the literature has provided little empirical evidence on the benefits of traditional immobilization and has indicated potential negative consequences, some authors have suggested that a culture of immobilization has been created without evidence of patient benefit. Although the effect of spinal immobilization on patient mortality and outcome remains uncertain due to the lack of randomized controlled trials, current guidelines strictly recommend spinal immobilization for patients with traumatic spinal cord injury. The practice of spinal immobilization remains controversial regarding its possible benefits or harms in trauma patients. Comparative studies are needed to evaluate the safety of cervical and spinal immobilization. The aim of this Mini-Review is to investigate whether the current systems of immobilization of a trauma patient still represent best practice in out-of-hospital emergency care.