Cervical Spinal Cord Injury Cranial Traction

Patients with spinal cord injury of cervical spine fractures, most of them have quadriplegia, urinary retention and intercostal muscle paralysis, respiratory weakness, especially high cervical spinal cord injury, breathing is more difficult, and due to instability of the cervical spine, can also increase cervical spinal cord injury, resulting in injury The situation is getting worse. In order to quickly stabilize the condition, it is necessary to perform early skull traction, and at the same time, emergency measures such as bladder indwelling catheterization and tracheotomy are performed. Skull traction has been widely used since Crutchfield's 1933 report. The dislocated cervical spine can be repositioned after traction, thus reducing or eliminating spinal cord compression and preventing fracture of the vertebrae and aggravating spinal cord injury. This method is still an effective treatment for spinal cord injury in cervical spine fractures. Treatment of diseases: cervical spine fracture and dislocation Indication Cervical spinal cord injury skull traction is suitable for: 1. Cervical fractures or fractures and dislocations with spinal cord injury. 2. Cervical dislocation, joint interlocking with spinal cord injury. 3. Reattachment after cervical spine injury, but there is still instability, accompanied by spinal cord injury. Contraindications Cervical spine with mild vertebral compression fractures and no symptoms of neurological damage. Preoperative preparation 1. Routine preparation before scalp surgery. 2. Skull traction clamps, traction frames and weight hammers. 3. Bed mats. Surgical procedure Drilling position Between the outer ear holes on both sides, along the longitudinal axis of the spine, connect the line through the head, 3 to 4 cm from the sides of the sagittal midline, poke the scalp with a sharp knife, with a special drill bit with protective edge in two Each side of the skull is drilled and deep into the skull barrier. The position of the borehole can also move the position of the bore forward or backward depending on the need for the traction axis to overstretch or bend. 2. Place the traction forceps Place the two nails of the Crutchfield tong in a drill hole and tighten the screw to fix the nail. 3. Traction Hang the traction frame on the bed, pull the rope around the pulley on the traction frame, hang the weight hammer, and raise the two feet of the bed to reverse the traction. 4. Cervical spine reduction The traction weight starts with 4kg, and the side of the cervical vertebra is taken at the bedside to observe the reset after traction; if it can not be reset, it can increase 2kg every 15min until it is reset (usually about 10kg), and the total weight does not exceed 15~20kg. After confirming the reset, the maintenance weight can be changed to 3 to 5 kg. 5. Traction time It takes 4 to 6 weeks. Then the head and neck plaster was fixed for 3 months. complication In the case of dural injury, hemorrhage, cerebrospinal fluid leakage, and purulent meningitis may occur, and the position of the traction forceps needs to be replaced.

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