Patients with cervical spine fracture-dislocation who cannot be examined during attempted closed reduction, or before open posterior reduction, should undergo cervical MRI before attempted reduction . The presence of a significant herniated disc in this setting is a relative indication for anterior decompression (e.g. by an anterior cervical discectomy and fusion – ACDF) before reduction.
A study of Aciduman and Belen from Ankara University, Turkey, presents information regarding the treatment of fractures and dislocations of the vertebrae, including the use of oral route for upper cervical fractures, presented in certain chapters of the book titled Kitāb al-'Umda fī Ṣinā'a al-Jirāḥa (Ibn al-Quff, 13th century AD).
A printed copy of the second volume of the book was studied. Chapters 22 (“On treatment of vertebral fractures”) and 33 (“On treatment of vertebral dislocation”) of the 17th treatise of this book were translated from Arabic into English. Each section is presented (in full text) in the Results section of this article. The findings were compared with the relevant literature and discussed to determine whether Ibn al-Quff presented novel information compared with that presented by his predecessors.
The writings of Ibn al-Quff regarding vertebral dislocations appear to summarize information derived from his predecessors. Moreover, he modified certain approaches, previously described for vertebral dislocations, and employed them for correcting vertebral fractures. Ibn al-Quff introduced the most novel use of a bridle-like instrument for anterior cervical fracture through the oral route. By introducing the device in the mouth, he described a pushing maneuver to the cervical vertebrae from the ventral site and a simultaneous pulling maneuver by cupping on the neck from the dorsal site.