Frequency of Improvement in Anatomical Alignment of Cervical Spine with Skeletal Traction in Patients with Cervical Spine Injury

OBJECTIVE: To determine frequency of improvement in anatomical alignment of cervical spine with skeletal traction in patients with cervical spine injury. METHODOLOGY: This retrospective observational study was conducted at neurosurgery department, Lady Reading Hospital, Peshawar. The medical record of all cases from December 2010 to November 2011, in which cervical traction was applied for cervical spine injury, was retrieved. Documentation was done according to proforma designed, indicating age, sex, status of radiological alignment of cervical spine before and after cervical traction and investigations with findings on X-rays, CT and MRI. The data was analyzed with respect to mechanism of injury, type of injury, duration of traction, and reduction outcome. RESULTS: Out of 33 patients with cervical spine injury, 21 (63.6%) were males and 12 (36.4%) were females. The age of the patients ranged from 13-80 years with mean age of 32.33+16.30 years. Majority of the patients (n=20, 60.6%) were young, ranging in age from 13-30 years. Complete radiological alignment was achieved in 20 (60.6%) cases, partial alignment in 2 (6.1%) cases and no alignment was successful in 11 (33.3%) cases. Traction was most effective in patients with C5C6 cervical subluxation (n=13, 86.7%). Improvement was noted in 100% (n=9) of patients with posterior subluxation. CONCLUSION: Skeletal cervical traction is safe and effective means of early decompression of spinal cord and establishing and maintaining alignment of cervical spine by close reduction. It is more effective in young individuals particularly those with subaxial spinal instability due to extension type of injury.