Manipulation for cervical spinal dislocation under general anaesthesia: serial review for 4 years

Area of Science:

• Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Cervical spinal dislocations require prompt reduction.
• Manipulation under anesthesia is a primary treatment method.
• Failure causes and neurological complications need clarification.

Purpose of the Study:

• To identify causes of failure in manipulation for cervical dislocations.
• To evaluate the effectiveness and safety of manipulation under anesthesia.
• To determine optimal treatment strategies based on dislocation type.

Main Methods:

• Retrospective review of 31 patients treated from 1991-1995.
• Detailed documentation of neurological progression and outcomes.
• Classification of dislocations into bilateral, unifacet, and fracture dislocations.

Main Results:

• 74% of dislocations were successfully reduced by manipulation alone.
• 26% of patients required open reduction.
• Failure of manipulation was predominantly due to co-existing fractures.
• Success rate: 90% for pure dislocations, 22% for fracture dislocations.

Conclusions:

• Manipulation under anesthesia is safe and effective for pure cervical spinal dislocations.
• Early identification of fractures is crucial for treatment planning.
• Open reduction should be considered for dislocations with associated fractures.