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[Reduction and positioning of cervical spine injuries]
1Unfallchirurgische Klinik, Medizinische Hochshule Hannover. Blauth.Michael@MH-Hannover.de
Zentralblatt Fur Chirurgie
|October 3, 1998
Summary
Accurate analysis and imaging are crucial for reducing cervical spine injuries. Halo-ring fixation and traction, with careful monitoring, aid in manual reduction, while specialized devices assist in operative interventions.
Area of Science:
- Orthopedics
- Neurosurgery
- Trauma Surgery
Background:
- Successful reduction of cervical spine injuries requires precise lesion analysis and classification.
- Imaging modalities like MRI and CT scans are essential to rule out disc protrusion before reduction, especially in locked dislocations.
Purpose of the Study:
- To outline the prerequisites and methods for successful reduction of cervical spine injuries.
- To describe the application of halo-ring fixation, skeletal traction, and specialized devices in managing these injuries.
- To highlight potential complications and risk factors associated with reduction maneuvers.
Main Methods:
- Manual reduction using a halo-ring under local anesthesia and fluoroscopic control.
- Halo-fixator for maintaining anatomical position until surgery.
- Skeletal traction with a halo-ring and weights (up to 20 kg) for locked dislocations and malalignments.
- Repeated clinical and neurological examinations to monitor for overdistraction or neurological deterioration.
- Intraoperative positioning device connected to the halo-ring for versatile head and spine fixation.
- Operative reduction for specific indications like posterior element fractures preventing closed reduction.
Main Results:
- Halo-ring fixation and skeletal traction are effective in managing cervical spine injuries, particularly locked dislocations.
- A specialized intraoperative device facilitates precise positioning and reduction in various patient positions.
- Neurological deterioration is the most severe complication, often linked to disc material dislocation into the spinal canal during reduction.
Conclusions:
- Exact analysis, appropriate imaging, and meticulous reduction techniques are paramount for successful outcomes in cervical spine injury management.
- Halo-ring fixation and traction are valuable tools, but careful monitoring is essential to prevent complications.
- Operative reduction carries risks, particularly posterior approaches, due to potential disc displacement.