Neurological complications of the reduction of cervical spine dislocations.
We have studied the case records of 16 patients with dislocations of the cervical spine who deteriorated neurologically during or after reduction. The dislocations were reduced by skull traction in four patients, by manipulation in four and by operation in seven. This complication was not related to age, sex, mechanism of injury, or the level and the type of dislocation. Fourteen patients made substantial recoveries, one made a partial recovery and one patient remained totally paralysed and died three months later. The causes and prevention of spinal-cord damage at this stage of management are discussed, and the early use of MRI or CT myelography is recommended.
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK.
Y J
YJ
Mahale
J R
JR
Silver
N J
NJ
Henderson
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008349:Manipulation, Orthopedic / Q000009:adverse effects*; D008875:Middle Aged; D009192:Myelography; D012017:Referral and Consultation; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014143:Traction / Q000009:adverse effects*; D016896:Treatment Outcome