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December 10, 1938

TREATMENT OF FRACTURE-DISLOCATION OF THE SPINE ASSOCIATED WITH CORD INJURY

Author Affiliations

RICHMOND, VA.; UNIVERSITY, VA.

From the Departments of Neurological Surgery, Medical College of Virginia and the University of Virginia Department of Medicine.

JAMA. 1938;111(24):2168-2172. doi:10.1001/jama.1938.02790500006002
Abstract

Injury to the cord by fracture-dislocation of the spine frequently demands that consideration be given to measures which will protect the cord from further injury by pressure of displaced bone. The impossibility of regeneration of the cord being accepted, it logically follows that the treatment of cord injuries, so far as restoration of function of the cord is concerned, is effective only in those cases in which the cord has not been entirely destroyed at the level of the vertebral lesion.

It is often stated that, because of the concussion and spinal shock associated with severe injuries to the cord produced by fracture-dislocation, it is impossible to make an early differentiation between complete physiologic interruption which may later show some recovery and a total transverse lesion which is permanent.1

It seems improbable that concussion is a factor of importance in cases of fracture-dislocation due to indirect violence. A better

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