For an alert patient with suspected cervical spine injury, what is the recommended approach to maintaining spinal motion restriction during transport?

• A. Keep the patient in a neutral alignment without stabilization
• B. Keep the head in neutral alignment with manual inline stabilization
• C. Allow movement to test stability
• D. Remove immobilization if patient cooperates

Answer: (B)

The key idea is to minimize movement of the cervical spine during transport. For a suspected cervical spine injury, maintaining spinal motion restriction means keeping the head in a neutral position and providing continuous manual inline stabilization of the head and neck. This prevents dangerous flexion, extension, or rotation as the patient is moved, transferred, or repositioned, reducing the risk of worsening spinal cord injury. In practice, this is typically done with MILS (manual inline stabilization) while the patient is kept in a neutral alignment, often alongside a cervical collar and immobilization setup as per protocol.

Choosing not to stabilize, or allowing movement to “test” stability, or removing immobilization because the patient is cooperative all increase the risk of further injury and are not appropriate in this scenario. Even an alert patient may have a cervical injury not readily evident, and any movement can aggravate it.