This website has been developed by the Burwood Spinal Unit to assist New Zealand trauma clinicians perform successful and timely closed reduction of appropriate patients with a cervical spinal cord injury in order to optimise their recovery


Increasing evidence suggests early decompression of cervical spinal cord injuries maximises neurological recovery. Decompression of the spinal cord can be achieved using craniocervical traction (‘closed reduction’) in selected awake patients. This website provides evidence-based step-by-step guidelines and resources to support regional centres perform this essential procedure. Occasionally an urgent closed reduction may be appropriate to perform prior to transfer. This critical decision is made on a case by case basis in consultation with the on-call spinal specialist (OCSS) for your region who is available for phone advice throughout the process.
The procedural protocol outlined on this website is not a standalone guideline and the resources provided are only an adjunct to the treating clinician’s care. We appreciate any feedback to assist in the continual development of this resource.



Dr Richard Storey MBChB, BMedSci (hons)
Orthopaedic Registrar CDHB
Mr Rowan Schouten FRACS, MBChB
Spine Surgeon CDHB
Dr Raj Singhal MBBS, FRCS, CCT Rehabilitation Medicine (UK), FAFRM (RACP)
Spinal Rehabilitation Specialist CDHB
Mr David Kieser FRACS, FNZOA, MBChB, PhD, PGDipSurgAnat, MedDip
Orthopaedic Surgeon CDHB
Dr Tom Inglis MBChB
Orthopaedic Registrar CDHB