Out-of-Hospital Management of Suspected Spinal Cord Injuries: How Much Evidence Does it Take to Change Practice?

The authors examine the ongoing debate regarding the practice of spinal immobilization in out-of-hospital management of suspected spinal cord injuries, questioning how much evidence is required to change established medical practices. They highlight the extensive multidisciplinary efforts and accumulated research over the past 25 years that consistently indicate spinal immobilization is harmful and lacks demonstrable benefits. The central inquiry is how many more studies and professional consensus are necessary before this practice is abandoned in favor of safer alternatives.