Chapter 18 Cervical Spine Traction with Gardner Wells Tongs
Overview
1. Cervical spine traction is accomplished with placement of calipers or tongs to the skull and attachment to a pulley system secured to the bed.
Precautions
1. Before application of cervical spine traction, consultation with the treating spine surgeon is paramount. Typically, unconscious or uncooperative patients require a magnetic resonance imaging (MRI) scan prior to reduction to rule out an associated disc herniation. Some controversy exists with regard to obtaining a prereduction MRI scan in patients who are awake and cooperative.
2. Repeat cervical spine radiography is essential. Use of a C-arm machine allows repeated radiography to evaluate the reduction as weights are added.
5. Ensure that the pressure-sensitive spring-loaded indicator on the pin protrudes by 1 to 2 mm to indicate 30 inch/pounds of pressure.
8. Gardner Wells tongs need to be retightened after 24 hours. However, they can only be retightened once.
Pearls
2. If an MRI scan is planned, ensure that the Gardner Wells tongs are made of MRI-compatible graphite tong and titanium pin system.