Abstract
Cervical bifacet dislocations are devastating injuries and require early reduction and surgical stabilization. Closed reduction is safe and neurological deterioration is rare. Pre-reduction MRI can cause clinical uncertainty as to the safety of closed reduction when a significant sequestrated disc is found. This study explores the direct cord pressures in a bifacet dislocation model with the use of fresh frozen cadaver cervical spines and a Tekscan Pressure Measurement System.
Method
Surgical dislocations were created and pressure monitors inserted into the canal. Pressures on the cord from the posterior-superior edge of the caudal body as well as that from the cranial body were assessed at the level of the dislocation. The effects of the presence of a disc and its size, reduction angles and level of dislocation before and during closed reduction were evaluated.
Results
The average dislocated spinal cord pressures were measured at 3.81 kPa and increased to 20.22 kPa under traction. This decreased to 1.295 kPa after cervical spine reduction. Average cord pressures as well as peak loading pressures were shown to increase with the increasing size of the prolapsed disc and diminished once the spine was reduced.
Conclusion
This model provides additional insight into cervical spine dislocation and the contribution of disc prolapse to cord injury.
NO DISCLOSURES
