Clinical outcome of closed reduction of cervical spine injuries in a cohort of Nigerians.
Spinal Cord Ser Cases
; 5: 17, 2019.
Article
em En
| MEDLINE
| ID: mdl-30774987
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos da Coluna Vertebral
/
Tração
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Vértebras Cervicais
/
Luxações Articulares
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article