{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T13:38:30Z","timestamp":1770817110232,"version":"3.50.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T00:00:00Z","timestamp":1504224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p> Current protocols for spine immobilization of the injured skier\/snowboarder have not been scientifically validated. Observing changes in spine alignment during common rescue scenarios will help strengthen recommendations for rescue guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Twenty-eight healthy volunteers (18 men, 10 women) age 47\u00b117 (range 20\u201373) (mean \u00b1SD with range) underwent a mock rescue in which candidate patrollers completing an Outdoor Emergency Care course performed spine immobilization and back boarding in 3 scenarios: 1) Ski helmet on, no c-collar; 2) helmet on, with c-collar; and 3) helmet removed, with c-collar. After each scenario, a lateral radiograph was taken of the cervical spine to observe for changes in alignment. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Compared with the control group (helmet on, no collar), we observed 9 degrees of increased overall (occiput\u2013C7) cervical extension in the helmet on, with collar group ( P &lt; .001), and 17 degrees in the helmet off, with collar group ( P &lt; .001). There was increased extension at the occiput\u2013C2 intersegment in the helmet on, with collar group (9 degrees, P &lt; .001) and at both the occiput\u2013C2 (9 degrees, P &lt; .001) and C2\u2013C7 (8 degrees, P &lt; .001) intersegments in the helmet off, with collar group. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Ski helmet removal and c-collar application each leads to increased extension of the cervical spine. In the absence of other clinical factors, our recommendation is that helmets should be left in place and c-collars not routinely applied during ski patrol rescue. <\/jats:p><\/jats:sec>","DOI":"10.1016\/j.wem.2017.03.009","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T22:31:14Z","timestamp":1499121074000},"page":"168-175","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Cervical Spine Alignment in Helmeted Skiers and Snowboarders With Suspected Head and Neck Injuries: Comparison of Lateral C-spine Radiographs Before and After Helmet Removal and Implications for Ski Patrol Transport"],"prefix":"10.1177","volume":"28","author":[{"given":"Jared","family":"Murray","sequence":"first","affiliation":[{"name":"University of Minnesota School of Medicine, Duluth Campus (Mr Murray) and St. Luke\u2019s Hospital, Orthopedics and Sports Medicine, Whiteside Institute for Clinical Research and the Spirit Mountain Ski Partol, Duluth, MN (Dr Rust)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Rust","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Medicine, Duluth Campus (Mr Murray) and St. Luke\u2019s Hospital, Orthopedics and Sports Medicine, Whiteside Institute for Clinical Research and the Spirit Mountain Ski Partol, Duluth, MN (Dr Rust)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,9,1]]},"reference":[{"key":"bibr1-j.wem.2017.03.009","author":"SnowSports Industries America","year":"2012","journal-title":"Snow Sports Participation Report"},{"key":"bibr2-j.wem.2017.03.009","author":"National Ski Areas Association","year":"2012","journal-title":"NSAA Fact Sheet [Internet]"},{"key":"bibr3-j.wem.2017.03.009","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512472045"},{"key":"bibr4-j.wem.2017.03.009","unstructured":"National Spinal Cord Statistics Center, University of Alabama Birmingham Physical Medicine and Rehabilitation Department. 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