Sabiston C P, Wing P C, Schweigel J F, Van Peteghem P K, Yu W
Department of Orthopaedic Surgery, Shaughnessy Hospital/University of British Columbia, Vancouver.
J Trauma. 1988 Jun;28(6):832-5. doi: 10.1097/00005373-198806000-00020.
Dislocation of the lower cervical spine (C3-T1) is associated with a high incidence of neurologic injury. Attempted closed reduction by skeletal traction with weights ranging up to 50 lb (23 kg) is considered standard care in North America, although these attempts are often unsuccessful. This retrospective review, over a 6-year span, of 39 patients with dislocations and facet locks of the lower cervical spine treated with closed reduction showed that 35 (90%) were successful. Recommended weight was exceeded in 22 patients (63%) with no deteriorations in neurologic status. If patients are monitored radiologically and neurologically throughout traction, up to 70% of body weight can be used safely. An algorithm for treatment is provided.
下颈椎（C3-T1）脱位与神经损伤的高发生率相关。在北美，尝试使用重达50磅（23千克）的重物进行骨骼牵引闭合复位被视为标准治疗方法，尽管这些尝试往往不成功。这项对39例下颈椎脱位和小关节交锁患者进行闭合复位治疗的6年回顾性研究表明，35例（90%）复位成功。22例患者（63%）超过了推荐重量，但神经功能状态并未恶化。如果在整个牵引过程中对患者进行放射学和神经学监测，可安全使用高达体重70%的重量。本文提供了一种治疗算法。
