2026, Number 1
Effectiveness of closed reduction using craniocervical traction for traumatic cervical facet dislocation in an academic center: a pilot study
Language: Spanish
References: 19
Page: 19-25
PDF size: 592.10 Kb.
ABSTRACT
Introduction: acute traumatic spinal cord injury resulting from cervical facet dislocation represents a significant physical, emotional, and economic burden for patients, their families, and society. Objective: this pilot study evaluates the efficacy of closed reduction using craniocervical traction in patients with subaxial cervical facet dislocation. Material and methods: the study included consecutive patients treated between January 2023 and February 2025 with a diagnosis of traumatic cervical subaxial cervical facet dislocation who underwent closed craniocervical traction reduction at a university academic center. Results: seventeen patients were included, of whom only 11 underwent closed reduction. Successful reduction rate was 90.9% with no additional neurological complications. Traction was performed under local anesthesia, with monitoring in the intensive care unit, and success was achieved even in late presentation cases (3-14 days after the injury). The most common complication was neck pain in 3 (27.3%) patients. Conclusions: craniocervical traction is an effective early therapeutic option with no reports of additional complications or neurological impairment associated with the procedure.REFERENCES
Gelb DE, Hadley MN, Aarabi B, Dhall SS, Hurlbert RJ,Rozzelle CJ, et al. Initial closed reduction of cervicalspinal fracture-dislocation injuries. Neurosurgery. 2013; 72: 73-83. Available in: https://journals.lww.com/neurosurgery/fulltext/2013/03002/initial_closed_reduction_of_cervical_spinal.10.aspx
Wilson JR, Vaccaro A, Harrop JS, Aarabi B, ShaffreyC, Dvorak M, et al. The impact of facet dislocationon clinical outcomes after cervical spinal cord injury:results of a multicenter north american prospectivecohort study. Spine (Phila Pa 1976). 2013; 38: 97-103.Available in: https://journals.lww.com/spinejournal/fulltext/2013/01150/the_impact_of_facet_dislocation_on_clinical.2.aspx
Badhiwala JH, Wilson JR, Witiw CD, Harrop JS, VaccaroAR, Aarabi B, et al. The influence of timing of surgicaldecompression for acute spinal cord injury: a pooledanalysis of individual patient data. Lancet Neurol. 2021;20: 117-126. Available in: https://www.sciencedirect.com/science/article/pii/S1474442220304063
Sousa A, Rodrigues C, Marques M, Amorim-BarbosaT, Rodrigues-Pinto R. Awake cranial traction andisolated anterior cervical discectomy and fusion inthe treatment of traumatic subaxial cervical facet jointdislocations: analysis of a cohort of 70 patients andpredictors of surgical failure. Int J Spine Surg. 2022;16: 256. Available in: https://www.ijssurgery.com/content/16/2/256.abstract
Cotler JM, Herbison GJ, Nasuti JF, Ditunno JFJr, AnH, Wolff BE. Closed reduction of traumatic cervicalspine dislocation using traction weights up to 140pounds. Spine (Phila Pa 1976). 1993;18: 386-390.Available in: https://journals.lww.com/spinejournal/fulltext/1993/03000/closed_reduction_of_traumatic_cervical_spine.15.aspx
Fehlings MG, Vaccaro A, Wilson JR, Singh A,Cadotte DW, Harrop JS, et al. Early versus delayeddecompression for traumatic cervical spinal cord injury:results of the surgical timing in acute spinal cord injurystudy (STASCIS). PLoS One. 2012; 7: e32037. Availablein: https://doi.org/10.1371/journal.pone.0032037
Vaccaro AR, Falatyn SP, Flanders AE, BalderstonRA, Northrup BE, Cotler JM. Magnetic ResonanceEvaluation of the Intervertebral Disc, SpinalLigaments, and Spinal Cord Before and AfterClosed Traction Reduction of Cervical SpineDislocations. Spine (Phila Pa 1976). 1999; 24:1210-1217. Available in: https://journals.lww.com/spinejournal/fulltext/1999/06150/magnetic_resonance_evaluation_of_the.7.aspx
Darsaut TE, Ashforth R, Bhargava R, Broad R, EmeryD, Kortbeek F, et al. A pilot study of magnetic resonanceimaging-guided closed reduction of cervical spinefractures. Spine (Phila Pa 1976). 2006; 31: 2085-2090.Available in: https://journals.lww.com/spinejournal/fulltext/2006/08150/a_pilot_study_of_magnetic_resonance_imaging_guided.12.aspx
Brodke DS, Anderson PA, Newell DW, Grady MS,Chapman JR. Comparison of anterior and posteriorapproaches in cervical spinal cord injuries. J SpinalDisord Tech. 2003; 16: 229-235. Available in: https://journals.lww.com/jspinaldisorders/fulltext/2003/06000/comparison_of_anterior_and_posterior_approaches_in.1.aspx