Which two conditions are contraindications to cervical traction?

• A. Acute cervical fracture and significant vertebral artery compromise or ligamentous instability
• B. Mild neck stiffness with no neurologic signs
• C. Prior cervical surgery without current symptoms
• D. Age over 80 with neck pain

Answer: (A)

When considering cervical traction, the critical issue is safety: traction must not be used if there’s a risk of displacing the spine, injuring the spinal cord, or compromising blood flow to the brain. The two absolute contraindications are an acute cervical fracture and any condition that seriously compromises the vertebral arteries or causes ligamentous instability. An acute fracture means applying traction could shift bone fragments or compress the spinal cord, leading to serious injury. Significant vertebral artery compromise or ligamentous instability means the spine cannot maintain proper alignment under traction, so the distraction forces could provoke dangerous movement or vascular events.

Mild neck stiffness without neurologic signs doesn’t indicate instability or vascular injury, so it isn’t a contraindication. Having had cervical surgery previously without current symptoms isn’t an automatic prohibition—traction may be considered with careful assessment of symptoms, hardware integrity, and imaging findings. Age over 80 with neck pain isn’t an automatic contraindication either; while age can raise caution due to comorbidities, the decision depends on the overall stability and absence of red flags. Always verify stability and vascular status with appropriate imaging and clinical evaluation before using traction.