When initiating spinal motion restriction on a patient with suspected cervical spine injury, what alignment is preferred if feasible?

• A. Neutral alignment when possible
• B. Flexion of the neck to open airway
• C. Full extension of the neck
• D. Rotation of the head toward the injury

Answer: (A)

Maintaining spinal movement to a minimum is the goal when starting spinal motion restriction for a suspected cervical spine injury. Neutral alignment is best because it keeps the head, neck, and spine in a straight, natural position, reducing the risk that even minor repositioning will worsen a fracture or dislocation or compress the spinal cord. Moving into flexion, extension, or rotation can increase injury by creating abnormal stresses on the injured cervical segments. If feasible, keep inline stabilization and apply the immobilization (collar, backboard) with the patient in neutral. If airway needs to be managed and requires a change in position, do so with as little movement as possible and with careful stabilization to preserve neutral alignment.