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closed_reduction_of_locked_facets

Closed reduction of locked facets

Contraindicated if traumatic cervical disc herniation is demonstrated on MRI.

Patients who cannot be assesed neurologically may be done using SSEP/MEP monitoring. Two methods of closed reduction:

Cervical traction:

Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated.

The diagnostic evaluation of cervical fracture-dislocations should include advanced imaging by MRI in order to fully understand the injury pattern prior to proceeding with spinal reduction maneuvers which may impose the imminent threat of a devastating iatrogenic injury to the spinal cord. The presented staged management by initial Halo fixation without attempts for spinal reduction, followed by a surgical decompression and multilevel fusion, appears to represent a feasible and safe strategy for patients at risk of a delayed neurological injury 1).

1)
Botolin S, VanderHeiden TF, Moore EE, Fried H, Stahel PF. The role of pre-reduction MRI in the management of complex cervical spine fracture-dislocations: an ongoing controversy? Patient Saf Surg. 2017 Sep 8;11:23. doi: 10.1186/s13037-017-0139-8. eCollection 2017. PubMed PMID: 28904564; PubMed Central PMCID: PMC5591568.
closed_reduction_of_locked_facets.txt · Last modified: 2018/03/19 11:59 by administrador