In fracture dislocations of the neck with signs of a cord lesion, it is desirable to relieve the cord of continuing pressure resulting from bony deformity. This may be done either: (1) indirectly by performing a laminectomy, going well above and below the lesion, followed by longitudinal splitting of the dura, i. e., a so-called decompression of the spinal cord, which permits displacement of the cord backward and frees it from the scissor-like compression resulting from the usual bony distortion; (2) directly by manipulation which reduces the dislocation, followed by fixation in normal position.
Many years ago, while on duty at Fordham Hospital, three successive fracture dislocations of the neck were treated by laminectomy and splitting of the dura; the interval between injury and operation varying from one to four days. In each case, when the dura was split over the traumatized area, the cord fractured and extruded damaged fragments.
TAYLOR AS. FRACTURE-DISLOCATION OF THE NECK: A METHOD OF TREATMENT. Arch NeurPsych. 1924;12(6):625–639. doi:10.1001/archneurpsyc.1924.02200060026003
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