CORD INJURY DURING REDUCTION OF THORACIC AND LUMBAR VERTEBRAL-BODY FRACTURE AND DISLOCATION

1. Crush fractures, involving the posterior wall of the vertebral body, and all fracture-dislocations are potentially dangerous from the standpoint of cord injury during reduction.

2. In the reduction of vertebral-body dislocation in the thoracic or lumbar region, it is essential that the alignment of the articular processes be determined accurately before reduction is attempted. If there is lateral disalignment, the reduction should be open, and flexion should be employed to disengage the locked processes.

3. Extension of the spine in the presence of vertebral-body dislocation with lateral displacement of the articular processes may injure the cord or nerve roots. It should never be employed until the articular processes are in line.

4. Traction alone will not free locked articular processes.

5. Vertebral-body fracture, involving the posterior wall of the centrum, is potentially dangerous from the standpoint of spinal-cord or nerve-root pressure.

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