Taoka Takuya, Takigawa Tomoyuki, Morita Takuya, Fukumoto Genta, Yagata Yukihisa, Tada Keitarou, Ishimaru Takahiko, Ishihara Takeshi, Ito Yasuo
Department of Orthopaedic Surgery, Kobe Red Cross Hospital, Kobe, Japan.
Department of Orthopaedic Surgery, Hyogo Emergency Medical Center, Kobe, Japan.
Spine Surg Relat Res. 2023 Dec 27;8(4):383-390. doi: 10.22603/ssrr.2023-0229. eCollection 2024 Jul 27.
Guidelines published in 2013 recommend early closed reduction for cervical spine dislocation. There are two types of closed reduction: manual reduction and traction. Manual reduction can be performed early. In addition, it can correct rotation and requires a short time for complete reduction. We perform manual reduction for cervical spine dislocation. This study aimed to evaluate early manual reduction's success rate and safety for cervical dislocation. We also examined the relationship between time to reduction and improvement in paralysis.
This retrospective cohort study included 361 patients with cervical spine injuries treated at our hospital between July 2010 and December 2021. We assigned patients to the early group if the time from injury to reduction was ≤6 hours and to the late group if >6 hours. We performed awake manual reduction on the patients. Furthermore, we compared reduction's success rate and safety, including neurological outcomes.
Overall, 46 patients were included in the study: 31 and 15 in the early and late groups, respectively. The success rate of reduction was 93%, and no neurological complications from reduction were observed. The neurological outcomes and reduction success rates were significantly superior in the early group than in the late group.
Neurological outcomes were significantly superior when reduction was performed within 6 hours than after 6 hours. Manual reduction can be performed early, safely, and easily. It is effective for cervical spine dislocation requiring early reduction for an excellent neurologic prognosis.
2013年发布的指南推荐对颈椎脱位进行早期闭合复位。闭合复位有两种类型：手法复位和牵引。手法复位可早期进行。此外，它能纠正旋转，且完全复位所需时间短。我们对颈椎脱位进行手法复位。本研究旨在评估早期手法复位治疗颈椎脱位的成功率和安全性。我们还研究了复位时间与瘫痪改善之间的关系。
这项回顾性队列研究纳入了2010年7月至2021年12月在我院接受治疗的361例颈椎损伤患者。如果从受伤到复位的时间≤6小时，我们将患者分配到早期组；如果>6小时，则分配到晚期组。我们对患者进行清醒手法复位。此外，我们比较了复位的成功率和安全性，包括神经学结果。
总体而言，46例患者纳入研究：早期组和晚期组分别为31例和15例。复位成功率为93%，未观察到复位引起的神经并发症。早期组的神经学结果和复位成功率显著优于晚期组。
6小时内进行复位时的神经学结果显著优于6小时后。手法复位可早期、安全且轻松地进行。对于需要早期复位以获得良好神经预后的颈椎脱位有效。
