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Conservative treatment of craniocervical instability includes physical therapy [10] [11] [better source needed] and the use of a cervical collar to keep the neck stable. Cervical spinal fusion is performed on patients with more severe symptoms. [citation needed]
The Hangman's fracture which is a fracture of the C2 vertebral body or dens of the cervical spine upon which the skull base sits to allow the head to rotate, can also be associated with atlanto-occipital dislocation. Despite its eponym, the fracture is not usually associated with a hanging mechanism of injury. [13]
According to a cohort study conducted on 75 subjects investigating the efficacy of Halo traction therapy found an improvement rate of 31% to 66% for the spine. They found a coronal curvature improvement of 19.6% for adolescents, and 12% for adults. Kyphosis had improved at a rate of 23.9% for adolescents.
The patient may be advised to wear a neck brace or collar (for up to 8 weeks) that serves to ensure proper spinal alignment. Wearing the brace heightens one's awareness of posture and positioning and helps prevent movements (e.g., sudden and/or excessive bending or twisting of the neck) that may aggravate or slow down the healing process.
Spinal decompression is the relief of pressure on the spinal cord or on one or more compressed nerve roots passing through or exiting the spinal column. [1] Decompression of the spinal neural elements is a key component in treating spinal radiculopathy , myelopathy and claudication .
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For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
It is not unusual for patients to walk in for treatment and have such a fracture discovered on X-rays. Only if the force of the injury is severe enough that the vertebral body of C2 is severely subluxed from C3 does the spinal cord become crushed, usually between the vertebral body of C3 and the posterior elements of C1 and C2. [citation needed]