Intraoperative neck positioning for maxillofacial procedures on patients with cervical spine injuries, is it safe to remove the collar?

Introduction: Concomitant cervical spine and maxillofacial injury is reported in 2.2-11% of trauma patients. High-risk c-spine injuries not requiring immediate fixation are immobilised in a semi-rigid collar support, interfering with assessment and timely treatment of maxillofacial injuries. This can lead to extensive (delayed) maxillofacial surgery once healing has occurred. We present (for the first time) magnetic resonance images (MRI) demonstrating the alignment of the cervical spine during common maxillofacial procedures in order to assist spinal surgeons in deciding whether it is safe to undertake surgery without collar support.

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