Asian Spine J.  2023 Oct;17(5):835-841. 10.31616/asj.2022.0409.

Immediate Closed Reduction Technique for Cervical Spine Dislocations

• Oae K
• Kamei N
• Sawano M
• Yahata T
• Morii H
• Adachi N
• Inokuchi K

• KMID: 2547580
• DOI: http://doi.org/10.31616/asj.2022.0409

Abstract

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.

Keyword

Cervical; Dislocation; Reduction; Spinal cord injuries; Outcomes