Skull Traction and Cervical Cord Injury

1. Front Matter

   Pages I-XIII

   PDF

2. Aggravation by Therapeutic Skull Traction of Cervical Cord Injury

   1. Front Matter

      Pages 1-1

      PDF

   2. Compressive Cervical Cord Injury and Therapeutic Skull Traction

      • Alf Breig

      Pages 3-16

   3. Mechanics and Biomechanics of Pons-Spinal Cord Section of Central Nervous System

      • Alf Breig

      Pages 17-23

   4. Deleterious Effects of Therapeutic Skull Traction: A Retrospective Study

      • Alf Breig

      Pages 24-37

   5. Cord Incision Model for Visualization of Adverse Effects of Skull Traction and Ventroflexion of Cervical Spine

      • Alf Breig

      Pages 38-46

   6. Future Treatment of Cervical Spine Injuries

      • Alf Breig

      Pages 47-51

   7. Summary of Part I

      • Alf Breig

      Pages 52-56

3. A New Approach to Improved Rehabilitation

   1. Front Matter

      Pages 57-57

      PDF

   2. Surgical Procedure for Cervicolordodesis

      • Alf Breig

      Pages 59-71

   3. Therapeutic Breadth of Surgically Secured Spinal Cord Relaxation

      • Alf Breig

      Pages 72-74

   4. Summary of Part II

      • Alf Breig

      Pages 75-81

   5. References

      • Alf Breig

      Pages 82-84

In this book on the optimal treatment of the injured spinal cord we present the reasons why we consider it necessary to handle trauma­ tized medullary tissue in accordance with the classical biological principles of wound healing in general, namely by long-term, ten­ sion-free immobilization of the spinal cord. Today, such immobili­ zation for this purpose can only be achieved by surgical secure­ ment of slight dorsiflexion of the cervical spine. Traumatically compressed medullary tissue is invariably attenu­ ated and weakened. On application of skull traction, the weakened section of the compressed cervical cord is the part that is most overstretched. This inevitably results in increased neurological def­ icit. On scrutiny of the clinical records of 100 tetraplegic patients treated by skull traction at the National Spinal Injuries Centre at the Stoke Mandeville Hospital, Aylesbury, England, from 1971 to 1982, we found that therapeutic skull traction had been followed by an immediate increase in neurological deficit in 12% of the patients - a relatively high figure for the type of case in which beneficial effects oftraction were habitually anticipated. Moreover, in studies on cadavers, artificial defects in fresh human cervical cord in situ showed typical deformation following application of traction, confirming the basic deleterious effects of therapeutic skull traction on the injured cervical cord.

• biomechanics
• central nervous system
• nervous system
• rehabilitation
• spinal cord
• spine
• surgery
• trauma

• Karolinska Hospital, Stockholm, Sweden

  Alf Breig

• Söderhamn, Sweden

  Alf Breig

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