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  4. Transoropharyngeal closed reduction for traumatic atlantoaxial dislocation: a novel technique for fast and precise reduction

Transoropharyngeal closed reduction for traumatic atlantoaxial dislocation: a novel technique for fast and precise reduction

International Orthopaedics, 2023 · DOI: https://doi.org/10.1007/s00264-023-05817-7 · Published: May 11, 2023

SurgeryOrthopedics

Simple Explanation

This study introduces a new surgical technique to quickly and accurately correct a traumatic atlantoaxial dislocation (TAAD), a condition where the top two vertebrae in the neck misalign due to injury. The technique involves a closed reduction performed through the oropharynx (the back of the mouth) under general anesthesia. The study found that this method was successful in all 18 patients, leading to improved clinical outcomes and imaging parameters.

Study Duration
January 2015 to December 2020
Participants
18 patients with acute TAAD
Evidence Level
Not specified

Key Findings

  • 1
    The transoropharyngeal closed reduction technique was successful in 100% of the patients with TAAD.
  • 2
    Patients experienced significant improvements in clinical outcomes, including increased JOA scores and decreased NDI and VASNP scores.
  • 3
    Radiological measurements showed significant improvements in ADI, SAC and CCA after the procedure.

Research Summary

This study introduces a rapid trans-oropharyngeal closed reduction technique for acute TAAD. The technique was found to be safe and effective, with a 100% success rate in the studied cohort. The study suggests this method provides a new strategy for the treatment of TAAD, offering a potential alternative to traditional cranial traction.

Practical Implications

Novel Treatment Strategy

The transoropharyngeal closed reduction offers a new treatment option for acute TAAD, potentially reducing the risks and discomfort associated with prolonged cranial traction.

Rapid Reduction

The technique facilitates rapid and precise reduction of the atlantoaxial joint, which is critical in severe cases to mitigate neurological and vascular injuries.

Improved Patient Outcomes

The study demonstrated significant improvements in clinical and radiological outcomes, indicating a positive impact on patients' recovery and quality of life.

Study Limitations

  • 1
    Retrospective, single-centre study
  • 2
    Lack of a comparative group undergoing other treatments
  • 3
    Small sample size

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