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KMID : 1189320230170050835
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Asian Spine Journal
2023 Volume.17 No. 5 p.835 ~ p.841
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Immediate Closed Reduction Technique for Cervical Spine Dislocations
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Kazunori Oae
Naosuke Kamei
Makoto Sawano
Tadashi Yahata
Hokuto Morii
Nobuo Adachi
Koichi Inokuchi
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Abstract
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Study Design : Retrospective study.
Purpose : This research aimed to assess the clinical outcomes of patients with traumatic cervical spine dislocation who underwent closed reduction employing our approach.
Overview of Literature : Bedside closed reduction is the quickest procedure for repairing traumatic cervical spine dislocations; nevertheless, it also possesses the risk of neurological deterioration.
Methods : For closed reduction, the patient’s head was elevated on a motorized bed, the cervical spine was placed at the midline, traction of 10 kg was applied, the motorized bed was gradually returned to a flat position, the head was lifted off the bed, and the cervical spine was slowly adjusted to a flexed position. The weight of traction was elevated by 5-kg increments until the positional shift was attained. Subsequently, the bed was gradually tilted while traction was applied again to return the cervical spine to the midline position.
Results : Of the 43 cases of cervical spine dislocation, closed reduction was carried out in 40 cases, of which 36 were successful. During repositioning, three patients experienced a temporary worsening of their neck pain and neurological symptoms that enhanced when the cervical spine was flexed. Closed reduction was conducted while the patient was awake; nevertheless, sedation was needed in three cases. Among the 24 patients whose pretreatment paralysis had been characterized by American Spinal Injury Association Impairment Scale (AIS) grades A?C, seven patients (29.2%) demonstrated an enhancement of two or more AIS grades at the last observation.
Conclusions : Our closed reduction approach safely repaired traumatic cervical spine dislocations.
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KEYWORD
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Cervical, Dislocation, Reduction, Spinal cord injuries, Outcomes
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