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Closed reduction of cervical spine dislocations
Clinical Orthopaedics and Related Research
|January 1, 1987
Summary
This study shows that closed reduction is a safe and effective treatment for cervical facet dislocations. Most patients achieved successful reduction without worsening neurological deficits, and many with incomplete spinal cord injuries improved.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Cervical facet dislocations are serious injuries requiring prompt and effective treatment.
- Understanding the anatomy and manipulation principles is crucial for successful reduction.
Purpose of the Study:
- To evaluate the safety and efficacy of a closed reduction treatment protocol for cervical facet dislocations.
- To assess the outcomes of closed reduction in patients with unilateral and bilateral facet dislocations.
Main Methods:
- Treatment involved axial skeletal traction, Stryker frame, Gardner-Wells tongs, and manipulation.
- Cadaver studies informed the anatomical understanding and manipulation techniques.
- 24 patients with cervical facet dislocations were treated between 1979 and 1983.
Main Results:
- Successful closed reduction was achieved in 17 out of 24 patients (71%).
- No patient experienced progression of neurologic deficit or facet fracture post-treatment.
- Of the 7 patients not reduced by closed methods, 90% (9 of 10) with incomplete spinal cord injuries showed at least one grade improvement using the Frankel classification.
Conclusions:
- The described treatment program is safe and effective for closed reduction of cervical facet dislocations.
- Closed reduction can be successfully achieved for both unilateral and bilateral facet dislocations.
- This approach offers a viable conservative option for managing cervical facet joint injuries.