A Comparison of Efficacy of Two Cervical Orthoses in Koreans

Choi, Han Sung; Park, Hyun Kyung; Hong, Hoon Pyo; Kim, Myung Chun; Ko, Young Gwan

Abstract

PURPOSE
This study was performed to evaluate the difference in effectiveness between two cervical orthoses, the Philadelphia collar (Philadelphia Collar Co., Philadelphia, PA) and the Stifneck (Laerdal, Armonk, NY), in their ability to restrict cervical motion in flexion, extension, lateral tilt, rotation, and intervertebral motion in Koreans.
METHODS
Ten volunteers, young Korean men (26~4 2years of age), with clinically and radiographically normal cervical spines were studied. The normal and unrestrictedranges of active cervical motion in flexion, extension, and lateral tilt were measured in each subject and compared with the motion permitted in each of the two cervical orthoses.
RESULTS
This study demonstrated the Stifneck collar's superiority over the Philadelphia collar in extension, rotation, and lateral tilt, but not in flexion. The efficacies of the two collars in restricting intervertebral movement are good except between the 1st and the 2nd cervical vertebrae. The reason is the cervical vertebrae do not move as one unit; paradoxical motion, the phenomenon of "snaking," occurs. Compared to the results for the cervical spines of a Caucasian population, our results revealed that the combined flexion-extension of the cervical spine was markedly less restricted with both cervical orthoses.
CONCLUSION
The first obvious implication of the "snaking phenomenon" is that measurements of "total overall" cervical spine motion may be misleading. The limited effectiveness of restriction at maximum combined flexion-extension suggests that the anatomy of the skull in Asians might differ from that of Caucasians, leading us to believe that a new type of orthosis based on Asian anatomy needs to be developed, and produced.