Cervical spine alignment in the immobilized ice hockey player - A computedtomographic analysis of the effects of helmet removal

To determine if helmet removal causes a significant increase in lordosis of the cervical spine in ice hockey players, we radiographically assessed the position of the cervical spine in subjects immobilized to a standard spine backboard wearing shoulder pads both with and without a helmet, Ten adult male volunteers (ages, 18 to 28 years) with no previous history of cervical spine injuries were fitted with an appropriately sized ice hockey helmet a nd shoulder pads and immobilized in a supine position to a standard spine b ackboard. Computerized tomographic lateral scout scans were obtained of the cervical spine for three conditions: 1) no equipment (control), 2) helmet and shoulder pads, and 3) shoulder pads only (helmet removed). With the hel met removed and the shoulder pads remaining, a significant increase in C2 t o C7 lordosis was found when compared with the other two conditions. Indivi dual segmental measurements revealed a significant increase in cervical lor dosis at the C6-7 level with the helmet removed compared with the helmet an d shoulder pads condition. Our results demonstrate that the removal of an i ce hockey helmet from a supine player causes a significant increase in lord osis (extension) of the cervical spine. We recommend that ice hockey helmet s not be removed from injured players, with rare exceptions, because doing so results in unnecessary motion of the cervical spine.