Patología traumática del raquis cervical inferior

A retrospective study on traumatic injuries of the inferior cervical spine has been done,in order to performe an algoritmic decision system attempting to standardize therapeuticcriteria in future cases. Patients presenting only with cervical sprain, whithout spinal orneurologicallesion, were not considered. During the period 1973-1982, 51 patients in theseconditions were admitted to the University of Valencia, being dístributed in 4 groups:1, injuries of the cervical spine without neurological manifestations, and without otherasociated traumatic lesion (16 cases); 11, injuries of the cervical spine without neurologicalmanifestations and presenting with some otber associated traumatic lesion (13 cases);111, injuries of the cervical spine with neurological symptoms and without any other associated traumatic lesion (9 cases); and IV, injuries of the cervical spine with neurologicalmanifestations and with some other traumatic lesion (13 cases). In stable lesions, a conservativeorthopedic and fisiotherapeutic treatment was always stablished, consisting ofcervical collarino and isometric exercices, that always offered good results. In unstablelesions (fractures-Iuxations), when reduction was not obtained by means of unbendingmethods (skeletal traction), preoperative reduction and surgical stabilization (intersomaticfusion through an anterior approach) were done. The same procedure was applied in caseswithout radiologic evidence of fusion at four weeks. In cases with neurological manifestationsthe unstable spine lesion was treated as previonsly described. In order to obtain anearly movilitation that prevents from adding new lesions, early surgical stabilization in thetetraplegic patients is recommended. In cases with stationary or progresive neurologicaldeficit a mielographic study was always performed. When a contrast stop was detected,surgical decompression and stabilization of the unstable spine are a, were always performedoIn cases with negative mielography, the prior conservative treatment associated tohigh dose corticotherapy was maintained. Tetraplegic patients after early surgical fusion,were referred to a special center for long-Iasting treatment and rehabilitation.

A retrospective study on traumatic injuries of the inferior cervical spine has been done,in order to performe an algoritmic decision system attempting to standardize therapeuticcriteria in future cases. Patients presenting only with cervical sprain, whithout spinal orneurologicallesion, were not considered. During the period 1973-1982, 51 patients in theseconditions were admitted to the University of Valencia, being dístributed in 4 groups:1, injuries of the cervical spine without neurological manifestations, and without otherasociated traumatic lesion (16 cases); 11, injuries of the cervical spine without neurologicalmanifestations and presenting with some otber associated traumatic lesion (13 cases);111, injuries of the cervical spine with neurological symptoms and without any other associated traumatic lesion (9 cases); and IV, injuries of the cervical spine with neurologicalmanifestations and with some other traumatic lesion (13 cases). In stable lesions, a conservativeorthopedic and fisiotherapeutic treatment was always stablished, consisting ofcervical collarino and isometric exercices, that always offered good results. In unstablelesions (fractures-Iuxations), when reduction was not obtained by means of unbendingmethods (skeletal traction), preoperative reduction and surgical stabilization (intersomaticfusion through an anterior approach) were done. The same procedure was applied in caseswithout radiologic evidence of fusion at four weeks. In cases with neurological manifestationsthe unstable spine lesion was treated as previonsly described. In order to obtain anearly movilitation that prevents from adding new lesions, early surgical stabilization in thetetraplegic patients is recommended. In cases with stationary or progresive neurologicaldeficit a mielographic study was always performed. When a contrast stop was detected,surgical decompression and stabilization of the unstable spine are a, were always performedoIn cases with negative mielography, the prior conservative treatment associated tohigh dose corticotherapy was maintained. Tetraplegic patients after early surgical fusion,were referred to a special center for long-Iasting treatment and rehabilitation.