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CERVICAL SPINAL CORD INJURY
The immediate course of action for injury at this level often includes placement of “tongs” on the head, for treatment of a dislocated vertebra. The two arms of the tongs are attached directly to the skull (under local anesthesia) with a pin on each side of the head. Weights are connected to the tongs by a pulley system, and the device is used to apply traction to (to stretch) the cervical spine. With increasing weight, the traction allows the dislocated bones to slip back into their proper positions gradually, thus preventing damage that could result if the bones were forced into position. Achieving proper alignment and stability of the spine is essential for a good recovery from spinal cord injury. Tongs are useful for realigning the spine, but surgery and/or bracing are necessary for long-term stability.Because the neck is highly flexible, it is difficult to stabilize it with a brace. The most effective kind of neck brace is called a halo brace. A ring of metal (the halo) is attached around the circumference of the head with small pins drilled directly into the skull (under local anesthesia). The pins are tightened to hold the halo firmly in place. The patient dons a hard plastic vest that fits close to the upper body, and the vest is attached to the halo by metal bars and joints. This gives the spinal cord and vertebral column tremendous stability, allowing the bones and ligaments to heal in their proper positions. The halo can cause some pain, but this usually decreases with time and can be controlled with mild pain relievers.
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