Which action is NOT a recommended step during spinal motion restriction?

• A. Releasing manual stabilization only after securing the patient to a long spine board
• B. Maintaining neutral alignment at all times
• C. Securing torso before head
• D. Removing helmet without maintaining c-spine

Answer: (C)

During spinal motion restriction, the priority is to keep the spine in neutral alignment and minimize movement, especially of the head and neck. Securing the torso before the head is not recommended because the head and neck must be stabilized first to prevent any shift or rotation that could occur as torso restraints are applied. If the torso is secured first, tightening the chest and pelvis straps can move or misalign the head and neck, risking an exacerbation of a cervical injury. The safer approach is to stabilize the head and neck in line with the spine (with manual stabilization and a collar) and then secure the torso to the board, so the head remains immobile throughout the process. The other steps align with SMR practices: maintain neutral alignment at all times, and release manual stabilization only after the patient is securely strapped to the board; helmet removal should be done with cervical spine precautions in place.