Initial Closed Reduction of Cervical Spinal Fracture-Dislocation Injuries
Neurosurgery (Impact Factor: 3.62). 03/2013; 72:73-83. DOI: 10.1227/NEU.0b013e318276ee02
In the data derived from the literature published to date, closed reduction of fracture/dislocation injuries of the cervical spine by traction-reduction appears to be safe and effective for the reduction of acute traumatic spinal deformity in awake patients. Approximately 80% of patients will have their cervical fracture dislocation injuries reduced with this technique. The overall permanent neurological complication rate of closed reduction is approximately 1%. The associated risk of a transient injury with closed reduction appears to be 2% to 4%. Closed traction-reduction appears to be safer than MUA. There are numerous causes of neurological deterioration in patients whom harbor unstable cervical spinal injuries. These include inadequate immobilization, unrecognized rostral injuries, overdistraction, loss of reduction, and cardiac, respiratory, and hemodynamic instability. Therefore, an appropriately trained specialist must supervise the treatment, including attempted closed reduction, of patients with cervical spine fracture dislocation injuries.
- The spine journal: official journal of the North American Spine Society 10/2013; 14(1). DOI:10.1016/j.spinee.2013.08.002 · 2.43 Impact Factor
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ABSTRACT: Facet joint dislocation is a traumatic injury, which frequently results in devastating clinical outcomes. In Western Australia (WA), Royal Perth Hospital (RPH) provides a statewide Spinal Trauma Service and accepts all referrals from the entirety of the state. The economies of distance in WA mean that there is often a considerable delay between initial presentation at the peripheral hospital and enlocation of the dislocation in Perth. This study aims to identify any prejudicial clinical outcomes as a consequence of this delay.European Spine Journal 10/2014; DOI:10.1007/s00586-014-3627-x · 2.07 Impact Factor
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ABSTRACT: Study design:Survey of expert opinion, feedback and final consensus.Objective:To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set.Setting:International working group.Methods:A committee of experts was established to select and define data elements. The data set was then disseminated to the appropriate committees and organizations for comments. All suggested revisions were considered and both the International Spinal Cord Society and the American Spinal Injury Association endorsed the final version.Results:The data set consists of nine variables: (1) Intervention/Procedure Date and start time (2) Non-surgical bed rest and external immobilization, (3) Spinal intervention-closed manipulation and/or reduction of spinal elements, (4) Surgical procedure-approach, (5) Date and time of the completion of the intervention or surgical closure; (6) Surgical procedure-open reduction, (7) Surgical procedure-direct decompression of neural elements, and (8 and 9) Surgical procedure-stabilization and fusion (spinal segment number and level). All variables are coded using numbers or characters. Each spinal intervention and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it.Conclusion:The International SCI Spinal Interventions and Surgical Procedures Basic Data Set was developed to facilitate comparisons of spinal interventions and surgical procedures among studies, centers and countries.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.182.Spinal Cord 11/2014; 53(2). DOI:10.1038/sc.2014.182 · 1.80 Impact Factor
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