Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review
| Autor: | Robert W. Molinari, Christine Molinari, Nathan B. Kaplan |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Neck pain Motorcycle accident business.industry Traumatic brain injury Radiography MEDLINE medicine.disease Article Surgery nonoperative management Distraction Physical therapy occipitocervical dislocation Medicine Orthopedics and Sports Medicine Neurology (clinical) craniocervical distraction injury Nonoperative management medicine.symptom business Halo device |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5690 2192-5682 |
| DOI: | 10.1055/s-0035-1566290 |
| Popis: | Study Design Literature review and case report. Objective Review the existing literature and report the successful nonoperative management of a two-level craniocervical ligamentous distraction injury. Methods A PubMed and Medline review revealed only three limited reports involving the nonoperative management of patients with craniocervical distraction injury. This article reviews the existing literature and reports the case of a 27-year-old man who was involved in a motorcycle accident and sustained multiple systemic injuries and ligamentous distraction injuries to both occipitocervical joints and both C1–C2 joints. The patient's traumatic brain injury and bilateral pulmonary contusions precluded safe operative management of the two-level craniocervical distraction injury. Therefore, the patient was placed in a halo immobilization device. Results The literature remains unclear as to the specific indications for nonoperative management of ligamentous craniocervical injuries. Nonoperative management was associated with poor outcomes in the majority of reported patients. We report a patient who was managed for 6 months in a halo device. Posttreatment computed tomography and flexion–extension radiographs demonstrated stable occipitocervical and C1–C2 joints bilaterally. The patient reported minimal neck pain and had excellent functional outcome with a Neck Disability Index score of 2 points at 41 months postoperatively. He returned to preinjury level of employment without restriction. Conclusions Further study is needed to determine which craniocervical injuries may be managed successfully with nonoperative measures. |
| Databáze: | OpenAIRE |
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