Is the logroll manoeuvre safe?
- Report By: Nick Payne - SpR in A&E
- Search checked by Owen McCormack - SpR in A & E
- Institution: Stepping Hill Hospital, Stockport
- Current web editor: Minnie Alexander - Senior Information Officer
- Date Submitted: 19th May 2002
- Last Modified: 6th May 2003
-
Status:
Blue (submitted but not checked)
Three Part Question
In [patients with suspected spinal injury] is [the logroll manoeuvre] [safe]?Clinical Scenario
A 25 year old man who has been involved in an RTA is brought into your department by the paramedics. He has signs of cord transection and is complaining of low back pain. You wonder if a logroll to examine his back is appropriate.Search Strategy
Medline 1966 - 2002, WinSpirs Silverplatter interface.[spinal instab* AND move*] [logroll OR log roll]
Search Outcome
25 papers were found, of which 1 was relevant.Relevant Paper(s)
| Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| McGuire et al. May 1987 USA | Healthy volunteer, T12-L1 # patient and cadaver with unstable +spine. | Radiographic observation of motion of T-L spine with interventions | Degree of movement at the T-L junction. | Logroll gave greatest movement. Spinal board and scoop offered adequate stabilization. | Small number Unblinded No clinical outcome |
Comment(s)
The evidence is weak to nil, and there is difficulty doing a PRCT in this area. If a logroll is unsafe, should spinal boards be used at all, as a logroll is required to get the patient off? Should we just be using scoops instead? Should we just leave them on the spinal board.Clinical Bottom Line
Insufficient evidence to justify a change in practice, but a logroll does not offer a totally safe way to either examine the back of a spinally injured patient, or move them off a spinal board, and this needs to be remembered in daily practice.References
- McGuire RA. Neville S. Green BA. Watts C. Spinal instability and the log-rolling maneuver. Journal of Trauma-Injury Infection & Critical Care. 27(5):525-31, 1987 May.