A Pilot Study of Magnetic Resonance Imaging-Guided Closed Reduction of Cervical Spine Fractures

Abstract

MRI monitoring in closed cervical reduction is a useful research tool for this technique. Closed reduction appears to be safe as used in this preliminary study and is effective in achieving immediate spinal cord decompression.

An algorithm for the management of posttraumatic cervical spondyloptosis

“…24 Although it has been a topic of debate, 2,25 pre-reduction MRI to rule out anterior compressive pathology is obtained by most neurosurgeons (76.7%) and 57.5% of orthopedic surgeons. 26 After diagnosis of traumatic cervical spondyloptosis, we believe all patients should undergo MRI to exclude anterior cord compression from a herniated disk or a hematoma prior to aggressive attempts at closed reduction. If significant anterior compressive pathology is present, then anterior decompression with intraoperative traction is pursued.…”

Management of Cervical Facet Dislocation

“…A recent study by Darsaut et al presented 17 patients with cervical fracture-dislocations treated with closed reduced with in-line axial traction under MRI guidance. 25 All patients tolerated traction without neurological worsening; interestingly, the investigators illustrated with a sequential MRI-aided reduction technique that a herniated disk could reconstitute itself into its respective disk space. A survey analysis of the Spine Trauma Study Group (STSG) resulted in highly variable opinions and no consensus on timing or utilization of MRI in cervical facet dislocations.…”

Subaxial Cervical Trauma

“…21,22 Despite this finding, there has been no documented report of permanent spinal cord injury in an awake, cooperative, neurologically intact patient under a controlled, closed reduction. 21,22 Despite this finding, there has been no documented report of permanent spinal cord injury in an awake, cooperative, neurologically intact patient under a controlled, closed reduction.…”