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Thoraco-Lumbar Spinal Instability during Variations of the Log-Roll Maneuver

Published online by Cambridge University Press:  28 June 2012

Robert E. Suter ,
Thomas V. Tighe ,
John Sartori  and
Kendell Reed
Robert E. Suter*
Affiliation:
Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, Tex.
Thomas V. Tighe
Affiliation:
University of California, Affiliated Residency in Emergency Medicine, Valley Medical Center, Fresno, Calif.
John Sartori
Affiliation:
Chairman, Department of Radiology, University of Osteopathic Medicine and Health Sciences, Des Moines, IA
Kendell Reed
Affiliation:
Chairman, Department of Surgery, University of Osteopathic Medicine and Health Sciences, Des Moines, IA
*
Department of Clinical Investigation, Brooke Army Medical Center, San Antonio, TX 78234-6200USA
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Abstract

Introduction:

The “log-roll” maneuver is a common method of moving patients with suspected spinal injuries despite the fact that there is very little published information concerning its effectiveness.

Methods:

Lateral thoraco-lumbar motion and rotation during five variations of the log-roll maneuver were examined radiographically in fourteen healthy adults. Variations included the addition of axial traction and alterations in subject arm position.

Results:

While no rotational differences were noted between variations, substantial differences in lateral displacement were identified between individual subjects and techniques. This variability seemed to be due to differences in individual body habitus, particularly the shoulder/thorax to pelvis proportions and the amount of periabdominal fat. The addition of traction decreased motion in 59% of attempts but increased motion in 18%. While definitive recommendations cannot be made based upon these data, only one variation of the log-roll techniques examined consistently minimized lateral spinal motion in subjects tested. This variation involved positioning the subject with arms fully extended at their sides with palms resting on the lateral portion of their thighs and maintaining this position throughout the procedure.

Conclusions:

Pending further studies, it may be advisable to utilize this variation in patients with suspected thoraco-lumbar trauma.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 7 , Issue 2 , June 1992 , pp. 133 - 138
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1992

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