Distraction extension injuries of the cervical spine. Academic Article uri icon

Overview

abstract

  • Twenty-four consecutive patients with cervical distraction extension injuries were retrospectively reviewed to study the safety and efficacy of various treatment protocols in this type of cervical spine injury. Sixteen of 24 patients with cervical distraction extension injuries underwent surgical stabilization. All patients undergoing surgical stabilization were noted to have a stable fusion at their latest follow-up. There were three instances of surgically related neurologic deterioration as a result of over-distraction of the anterior column interspace at the time of graft placement. The overall mortality rate was 42% in this aged patient population. Anterior reconstruction of the cervical spine with an anterior cervical graft and plate acting as a tension band is the ideal treatment method for stabilization of acute distraction extension injuries involving primarily the soft tissue structures (anterior longitudinal ligament and intervertebral disc). Type 2 injuries, depending on the degree of displacement and the adequacy of closed reduction, may need to be approached initially posteriorly to obtain adequate alignment, followed by an anterior reconstructive procedure. Great care should be taken during anterior graft placement to avoid over-distraction of the spine. If nonsurgical intervention is selected, close regular radiographic follow-up is necessary to detect early vertebral malalignment, which may predispose to spinal cord dysfunction. Older patients sustaining this injury have a high mortality rate.

publication date

  • June 1, 2001

Research

keywords

  • Cervical Vertebrae
  • Wounds and Injuries

Identity

Scopus Document Identifier

  • 0034976026

Digital Object Identifier (DOI)

  • 10.1097/00002517-200106000-00002

PubMed ID

  • 11389368

Additional Document Info

volume

  • 14

issue

  • 3