Fractures and dislocations of the cervical spine

Abstract

T HE recent revival of interest in the treatment of injuries of the spine has resuhed from recognition that the adequate reduction of the dispIacement often Ieads to compIete cure or at any rate to marked reduction in the residua1 disability. This has proved as important in the injuries of the cervica1 region as in those occurring eIsewhere, for aside from those injuries produced by the hangman’s knot, the spina cord is often not seriousIy injured and is frequentIy capable of recovery if the dispIacement is reduced. HospitaI practice and experience in these injuries must vary greatly with the character of the community served and with the quaIifications of the staff. Thus, the orthopedic service is IikeIy to see many patients whose compIaints are chieAy pain, deformity and stiffness of the neck, whereas the neurosurgica1 department wiI1 see others who have varying degrees of involvement of the nervous system. The combined opinion of these two departments in this hospital, however, based on observations extending over ten years, is that most of the cases that are brought to the hospita1 alive have no, or onIy sIight injury to the cord and that even many of those with signs of a cord Iesion may be expected to show progressive recovery when the pressure on the cord has been re1ieved.l It is not the function of a symposium such as this to dea1 with the subject as in a textbook, but it is rather to draw attention to ideas that are new and to viewpoints that have changed. I shaI1 say nothing, therefore, in regard to the anatomy, the etioIogy and the diagnosis except to point out that any patient who has had an injury of the neck and who continues to compIain of pain or stiffness or who hoIds his head in ONTARIO