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Early versus delayed reduction of cervical spine dislocation with complete motor paralysis: a multicenter study

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Abstract

Purpose

Reduction of cervical facet dislocation should be performed as soon as possible to depressurize neuron cells although some randomized control studies defined early reduction as over 24 h after trauma. The purpose of this study was to define the actual time limit for early reduction in patients with complete motor paralysis.

Methods

Cervical spine dislocation patients with complete motor paralysis admitted between April 2007 and December 2014 were analyzed as retrospective cohort study. We separated the patients into three groups according to the number of hours lapsed between the trauma and reduction, within 4 h (very early group), >4–6 h (early group), and >6 h (delayed group). We compared the neurological outcomes, patient injury patterns, the arrival time at the hospital, and the injury severity score (ISS).

Results

Of 30 patients who enrolled, 8 (27%) were recovered to American Spinal Injury Association Impairment Scale Grades C-E. The delayed group had poorer neurological outcomes than the very early group and early group, although no significant differences were noted in the recovery rate between the very early group and early groups. The injury pattern, arrival time, and ISS were not found to be associated with the neurological outcome.

Conclusion

Our data suggest that early (<6 h) reduction of cervical spine dislocation is associated with favorable neurological outcome as compared with those performed after 6 h.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo, 130-8575, Japan

    Kosei Nagata, Keisuke Ishii, Atsuki Kobayashi & Hiroyuki Kanai

  2. Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Koichi Inokuchi

  3. The University of Tokyo Hospital, Tokyo, Japan

    Hirotaka Chikuda

  4. Yokohama Rosai Hospital, Yokohama, Japan

    Hiroyuki Nakarai & Kota Miyoshi

Authors
  1. Kosei Nagata
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  2. Koichi Inokuchi
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  3. Hirotaka Chikuda
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  4. Keisuke Ishii
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  5. Atsuki Kobayashi
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  6. Hiroyuki Kanai
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  7. Hiroyuki Nakarai
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  8. Kota Miyoshi
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Correspondence to Kosei Nagata.

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Conflict of interest

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

No funds were received in support of this work. Our study was approved by the institutional review board.

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The manuscript submitted does not contain information about medical device (s)/drug (s).

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Nagata, K., Inokuchi, K., Chikuda, H. et al. Early versus delayed reduction of cervical spine dislocation with complete motor paralysis: a multicenter study. Eur Spine J 26, 1272–1276 (2017). https://doi.org/10.1007/s00586-017-5004-z

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  • DOI: https://doi.org/10.1007/s00586-017-5004-z

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