Spinal cord damage from injury causes long-term disability and can dramatically affect quality of life. The current practice of immobilising trauma patients before hospitalisation to prevent more damage may not always be necessary, as the likelihood of further damage is small. Means of immobilisation include holding the head in the midline, log rolling the person, the use of backboards and special mattresses, cervical collars, sandbags and straps. These can cause tissue pressure and discomfort, difficulty in swallowing and serious breathing problems.
The review authors could not find any randomised controlled trials of spinal immobilisation strategies in trauma patients. It is feasible to have trials comparing the different spinal immobilisation strategies. From studies of healthy volunteers it has been suggested that patients who are conscious, might reposition themselves to relieve the discomfort caused by immobilisation, which could theoretically worsen any existing spinal injuries.