Awake Early Manual Reduction Is Highly Effective for Subaxial Cervical Spine Dislocation

Area of Science:

• Orthopedics
• Neurosurgery
• Trauma Surgery

Background:

• Current guidelines recommend early closed reduction for cervical spine dislocation.
• Manual reduction is a viable early intervention for cervical spine injuries.
• The efficacy of early manual reduction requires further investigation.

Purpose of the Study:

• To evaluate the success rate and safety of early manual reduction for cervical spine dislocation.
• To examine the relationship between the time to reduction and neurological improvement in paralyzed patients.

Main Methods:

• Retrospective cohort study of 361 patients with cervical spine injuries (July 2010 - December 2021).
• Patients divided into early (≤6 hours) and late (>6 hours) groups based on time to reduction.
• Awake manual reduction performed; success rate, safety, and neurological outcomes compared between groups.

Main Results:

• 46 patients included: 31 in the early group, 15 in the late group.
• Overall reduction success rate was 93% with no neurological complications.
• The early group demonstrated significantly superior reduction success rates and neurological outcomes.

Conclusions:

• Early manual reduction (within 6 hours) for cervical spine dislocation leads to superior neurological outcomes.
• Manual reduction is a safe, easy, and effective early treatment option.
• Timely intervention is crucial for an excellent neurologic prognosis in cervical spine dislocations.