Abstract:
Aim: To systematically review the literature on the effectiveness of cervical orthoses in reducing burners/stingers and cervical cord neurapraxia (CCN). Data Sources: In accordance with the Preferred Reporting Items for Systematic Review (PRISMA) statement, online databases (Medline, PubMed and Embase) were searched from inception to identify eligible studies. Study Selection: Studies investigating cervical orthoses in the prevention of burners and CCN were included for review. There were no limitations on study design. The utility of cervical orthoses in reducing burners and CCN was the primary end point. Data Extraction and Synthesis: Four studies met criteria for inclusion in the review. Only one study reported reduced incidence of burners when a neck collar was used, however, small numbers and non-randomised design limit this finding. All collars significantly reduced hyperextension, but failed to replicate this limitation for lateral flexion. The Kerr Collar is most effective at reducing compressive load in an axial direction. The A Force Neck Collar, Neck Roll and the Cowboy Collar limited active lateral flexion significantly more than passive lateral flexion. Conclusions: There remains a paucity of data regarding the efficacy of cervical collars in reducing burners and CCN in contact sports. All studies tested cervical orthoses in the setting of American Football. They suggest that it may be possible to reduce the incidence of injury through limiting cervical range of motion and protecting Erb’s point; however, in the clinical setting this has yet to be proven in a game or practice situation and any link to injury reduction is purely theoretical. Further studies are required to determine their efficacy, not only in this setting, but also in Rugby Union and Rugby League.