Introduction: Turning patients with cervical spine injury to prone position may produce movement of unstable segment and neurological deterioration.There are various transfer techniques to minimize this problem.Two methods are log roll technique and use of Jackson table.Studies revealed that log rolling produces significant motion in the unstable spine which may produce neurological deficits.Jackson table is not widely available in developing countries.We introduce a modified log rolling technique where the extend of neck movements in all planes is minimal.
Methods: Aim of study is to assess the extent of movement of neck in all three planes in an anaesthetized patient while being turned to prone position using the modified log rolling technique and to compare it with conventional method.We studied the range of movement of neck by tracking relative positions of markers kept over head,chest and back of neck.Patient's arms are abducted and kept abutting the head as a splint to stabilize head while patient is turned to prone position.We compared the range of movement of neck in 50 patients each with conventional and modified methods.
Results: The average value of degree of movement in sagital,coronal and axial planes were 16,7 and 5 respectively in modified technique and 23,19 and 27 with in conventional method.The result shows that maximum neck movement is taking place in axial plane and it is most effectively restricted by the new method.Movements in other planes are also restricted significantly.No complications like neuropraxia were associated with this technique and less man power required as compared to conventional method.
Conclusions: Conventional log rolling is associated with significant neck movement,especially in axial plane which may produce secondary neurological deficits.Modified technique significantly reduces the movements and avoids the need for special tables which many hospitals in developing countries can not afford.Modified technique is easy and need no additional person.
Patient Care: Study helps to introduce a new technique to turn spine injury patients to prone position which significantly reduces the neck movements compared to conventional method.It is especially useful in developing countries where spine tables are not widely available.
Learning Objectives: objective of this paper is to highlight the benefits of modified log rolling technique especially with respect to the restriction of neck movements in unstable spine.It is very helpful in developing countries where special spine tables are not widely available.