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Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review
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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671892/ https://www.ncbi.nlm.nih.gov/pubmed/26682101 http://dx.doi.org/10.1055/s-0035-1566290 |
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author | Kaplan, Nathan B. Molinari, Christine Molinari, Robert W. |
author_facet | Kaplan, Nathan B. Molinari, Christine Molinari, Robert W. |
author_sort | Kaplan, Nathan B. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4671892 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-46718922015-12-17 Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review Kaplan, Nathan B. Molinari, Christine Molinari, Robert W. Global Spine J Article 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. Georg Thieme Verlag KG 2015-12 /pmc/articles/PMC4671892/ /pubmed/26682101 http://dx.doi.org/10.1055/s-0035-1566290 Text en © Thieme Medical Publishers |
spellingShingle | Article Kaplan, Nathan B. Molinari, Christine Molinari, Robert W. Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title | Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title_full | Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title_fullStr | Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title_full_unstemmed | Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title_short | Nonoperative Management of Craniocervical Ligamentous Distraction Injury: Literature Review |
title_sort | nonoperative management of craniocervical ligamentous distraction injury: literature review |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671892/ https://www.ncbi.nlm.nih.gov/pubmed/26682101 http://dx.doi.org/10.1055/s-0035-1566290 |
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