Study design: A prospective observational study. Objectives: To evaluate the effectiveness of closed reduction of cervical spine injuries (CSIs) using cervical traction and identify probable complications. Setting: Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Methods: Consecutive CSIs managed by closed reduction using Gardener-Well's Tongs traction were prospectively analysed. The data included imaging and neurological examinations findings, Frankel grading, and extent of reduction. Reduction of 95% or more was deemed satisfactory. The primary outcome measures were extent/degree of reduction and neurologic status classified as improved, same, or worse. Other complications were taken as secondary outcome measures. Result: Seventy-four patients, 49 males, mean age 35.2 years (SD 9.7) were included. In all, 78.4% presented within 72 hours of injury. In total, 85.1% had road traffic crashes. Anterior subluxation was seen in 86.5%. The degree of displacement was <25% in 36/74 (48.6%), 25-50% in 19/74 (25.7%), 50-75% in 8/74 (10.8%), and >75% in 11/74 (14.9%). Traction reduction was done after 7 days of injury in 52.7% and same day of injury in 1.4%. Reduction weight ranged from 2 kg to 60 kg. Reduction was satisfactory in 67.6% and failed in 32.4%. In all, 81.1% of patients remained neurologically the same, while 18.9% improved. Causes of failed reduction were facet lock (15), old injury (8), new-onset/worsening pain (3), and over-distraction (2). Complications of closed reduction were over-distraction (5), tong pull-out (2), new-onset/worsening pain (2), and skull perforation (1). Conclusions: Satisfactory closed reduction is feasible in patients with CSI and significant malalignment. The method is associated with few complications.
Study design: A prospective observational study. Objectives: To evaluate the effectiveness of closed reduction of cervical spine injuries (CSIs) using cervical traction and identify probable complications. Setting: Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria. Methods: Consecutive CSIs managed by closed reduction using Gardener-Well's Tongs traction were prospectively analysed. The data included imaging and neurological examinations findings, Frankel grading, and extent of reduction. Reduction of 95% or more was deemed satisfactory. The primary outcome measures were extent/degree of reduction and neurologic status classified as improved, same, or worse. Other complications were taken as secondary outcome measures. Result: Seventy-four patients, 49 males, mean age 35.2 years (SD 9.7) were included. In all, 78.4% presented within 72 hours of injury. In total, 85.1% had road traffic crashes. Anterior subluxation was seen in 86.5%. The degree of displacement was <25% in 36/74 (48.6%), 25-50% in 19/74 (25.7%), 50-75% in 8/74 (10.8%), and >75% in 11/74 (14.9%). Traction reduction was done after 7 days of injury in 52.7% and same day of injury in 1.4%. Reduction weight ranged from 2 kg to 60 kg. Reduction was satisfactory in 67.6% and failed in 32.4%. In all, 81.1% of patients remained neurologically the same, while 18.9% improved. Causes of failed reduction were facet lock (15), old injury (8), new-onset/worsening pain (3), and over-distraction (2). Complications of closed reduction were over-distraction (5), tong pull-out (2), new-onset/worsening pain (2), and skull perforation (1). Conclusions: Satisfactory closed reduction is feasible in patients with CSI and significant malalignment. The method is associated with few complications.
Authors: Tim E Darsaut; Robert Ashforth; Ravi Bhargava; Robert Broad; Derek Emery; Frank Kortbeek; Robert Lambert; Mitch Lavoie; James Mahood; Ian MacDowell; Richard J Fox Journal: Spine (Phila Pa 1976) Date: 2006-08-15 Impact factor: 3.468
Authors: M N Hadley; B C Walters; B C Grabb; N M Oyesiku; G J Przybylski; D K Resnick; T C Ryken Journal: Neurosurgery Date: 2002-03 Impact factor: 4.654
Authors: El Fatemi Nizare; Bouchaouch Abdelali; Derkaoui Hassani Fahd; Oudrhiri Mohammed Yassad; Gana Rachid; El Maaqili Rachid; Bellakhdar Fouad Journal: Pan Afr Med J Date: 2013-06-20