Kleyn P J
Paraplegia. 1984 Oct;22(5):271-81. doi: 10.1038/sc.1984.45.
This paper reviews 101 patients with dislocations and fracture-dislocations of the cervical spine with neurological involvement, treated by closed reduction under anaesthesia. All were admitted to a specialised unit where early accurate diagnosis was followed by the application of Crutchfield tongs and an early attempt at closed reduction. Of the 101 patients so treated, 82 were fully reduced. Partial reduction was obtained in six. Open reduction and posterior fusion was performed on four patients following failed closed reduction. Open reduction was not attempted in 9 patients because of their poor general condition. Twenty three patients had delayed spinal fusion because of instability demonstrated radiologically at between 6 weeks and 12 weeks. Of the 56 patients with complete lesions, five showed major neurological recovery after 6 months, and there were 10 deaths at periods from 4 to 25 days after injury. Of the 45 patients with incomplete lesions, six made a full clinical recovery, 28 made major recovery, and there were three deaths from 9 to 14 days after injury. Our results lead us to believe that the method is safe and reliable, even in patients received over 24 hours after the injury.
本文回顾了101例颈椎脱位及骨折脱位合并神经损伤的患者，这些患者均接受了麻醉下闭合复位治疗。所有患者均入住专门科室，早期准确诊断后应用克氏钳，并尽早尝试闭合复位。在接受该治疗的101例患者中，82例完全复位，6例部分复位。4例闭合复位失败后行切开复位及后路融合术。9例患者因全身状况差未尝试切开复位。23例患者因伤后6至12周影像学显示脊柱不稳定而延迟行脊柱融合术。在56例完全性损伤患者中，5例在6个月后有明显神经功能恢复，10例在伤后4至25天死亡。在45例不完全性损伤患者中，6例临床完全恢复，28例有明显恢复，3例在伤后9至14天死亡。我们的结果使我们相信，即使是在伤后超过24小时才接受治疗的患者中，该方法也是安全可靠的。
