NOVEL APPROACH TO THE CRANIAL CERVICAL SPINE: INSTRUMENTED INTRAOPERATIVE DISTRACTION FOR TREATMENT OF C2 FRACTURES ANDAA LUXATION

摘要

Surgical treatment of cervical fracture-luxations is indicated if vertebral column instability is present or if spinal cord compression exists. Anatomic reduction and rigid fixation of fracture fragments is required to restore the integrity of the vertebral canal and thereby alleviate spinal cord compression. To aid in the reduction of cervical fractures, axial traction/distraction can be performed similar to that described for relief of spinal cord compression in cases of caudal cervical spondylomyelopathy. Manual traction of the head, or a variety instrumentation can be used to obtain this distraction, either by placement of the retractors in the adjacent fenestrated disc spaces (modified Gelpi or Scoville-Haverfield self-retaining laminectomy retractor - SHLR), or by use of a cervical distractor that temporarily screws into the vertebral bodies adjacent to the affected area.