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November 10, 1978

Treatment of Fracture Dislocations of the Spine

JAMA. 1978;240(20):2154. doi:10.1001/jama.1978.03290200032010

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To the Editor.—  I am writing in regard to the article in the MEDICAL NEWS section of The Journal (239:1597, 1978).I strongly disagree with Dr Labbé's reported conclusions regarding the treatment of fracture dislocations of the spine based on his experience in the disaster situation in the Guatemala City earthquake in 1976. The conclusion that decompressive laminectomy is the wrong treatment of fracture dislocations of the spine is based on a situation that I do not think is applicable to most circumstances in which fracture dislocations of the spine are seen and treated in major metropolitan medical centers in this country. His conclusions particularly regarding the high infection rate that they saw in Guatemala City would not apply to normal circumstances in this country. I find no disagreement with his contention that stabilization of the spine in fracture dislocations is important; however, others' experience in this field, particularly with