Initial closed reduction of cervical spinal fracture-dislocation injuries

In the data derived from the literature published to date, closed reduction of fracture/dislocation injuries of the cervical spine by traction-reduction appears to be safe and effective for the reduction of acute traumatic spinal deformity in awake patients. Approximately 80% of patients will have their cervical fracture dislocation injuries reduced with this technique. The overall permanent neurological complication rate of closed reduction is approximately 1%. The associated risk of a transient injury with closed reduction appears to be 2% to 4%. Closed traction-reduction appears to be safer than MUA. There are numerous causes of neurological deterioration in patients whom harbor unstable cervical spinal injuries. These include inadequate immobilization, unrecognized rostral injuries, overdistraction, loss of reduction, and cardiac, respiratory, and hemodynamic instability. Therefore, an appropriately trained specialist must supervise the treatment, including attempted closed reduction, of patients with cervical spine fracture dislocation injuries.