Is the logroll manoeuvre safe?
Date First Published:
May 19, 2002
Last Updated:
May 6, 2003
Report by:
Nick Payne, SpR in A&E (Stepping Hill Hospital, Stockport)
Search checked by:
Owen McCormack, Stepping Hill Hospital, Stockport
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.
Search Details:
[spinal instab* AND move*] [logroll OR log roll]
Outcome:
25 papers were found, of which 1 was relevant.
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Spinal instability and the log-rolling maneuver. McGuire RA. Neville S. Green BA. Watts C. May-87 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 |
Author Commentary:
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.
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.