title: Management of neglected cervical spine dislocation: a study of six cases.
abstract: OBJECTIVE
  To report a case series of six neglected cervical spine dislocations without neurological deficit, which were managed operatively.
  
  
  METHODS
  The study was conducted from August 2010 to December 2011 and cases were selected from the out-patient department of Postgraduate Institute of Medical Education and Research, India. The patients were in the age group of 30 to 50 years. All patients were operated via both anterior and posterior approaches.
  
  
  RESULTS
  During the immediate postoperative period, five (83.33%) patients had normal neurological status. One (16.67%) patient who had C5-C6 subluxation developed neurological deficit with sensory loss below C6 level and motor power of 2/5 in the lower limb and 3/5 in the upper limb below C6 level.
  
  
  CONCLUSIONS
  There is no role of skull traction in neglected distractive flexion injuries to cervical spine delayed for more than 3 weeks. Posterior followed by anterior approach saves much time. If both approaches are to be done in the same sitting, there is no need for instrumentation posteriorly. But if staged procedure is planed, posterior stabilization is recommended, as there is a risk of deterioration in neurological status.
authors.affiliation: Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Goni
authors.forename: Nirmal Raj
authors.initials: NR
authors.lastname: Gopinathan
authors.forename: Vibhu
authors.initials: V
authors.lastname: Krishnan
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Avinash
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D007194:India; D004204:Joint Dislocations / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013124:Spinal Injuries / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome