The first major advance in the out-of-hospital management of spinal cord injury came with the development of the semi–rigid cervical collar.
The original designs included two-piece rigid plastic models which had to be “sized” or measured for the individual, and several sizes need to be carried in order to best suit any injured person.
The next step in the development was a more flexible collar which could be folded flat and stored or carried between uses, and then shaped to the individual when it was required.
Further along in the development of the cervical collar came multi-fit models that could be adjusted when in place on the individual so that only an adult and paediatric size need to be carried.
The latest development includes semi-rigid collars with an extension piece below the level of the T1 vertebra designed to provide a greater level of support below the level of injury.
The X-collar is such an extended collar, a new design with all the features of a multi-fit semi rigid and the addition of an extension piece from the base of the collar that folds down and is positioned against the upper thoracic spine.
In this fashion, it attempts to provide splinting at, above and below the level of injury in a single unit rather than requiring the use of a spineboard and head immobilisation device.
The X-collar also has crossing straps which allow the unit to be positioned in the neutral alignment, but also “off-centre” if the neck is not able to be returned to the neutral position for any of the reasons previously described.