Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine

Ly Minh Ngo, Toshimi Aizawa, Takeshi Hoshikawa, Yasuhisa Tanaka, Tetsuro Sato, Yushin Ishii, Shoichi Kokubun

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose The combination of a facet fracture and a contralateral facet dislocation at the same intervertebral level of the cervical spine (a fracture and contralateral dislocation of the twin facet joints) has not been described in detail. The aims of this study are to report a series of 11 patients with this injury, to clarify the clinical features and to discuss its pathomechanism. Methods Among 251 patients with lower cervical spine fractures and/or dislocations surgically treated, 11 (9 males and 2 females, averaged age, 52 years) had this kind of injury. Medical charts and medical images were reviewed retrospectively. Results Injury levels were C4-5, C5-6 and C6-7 in 1, 4 and 6 patients, respectively. A fracture was found at the superior facet in 6, and at the inferior facet in 5. The anterior displacement of the vertebral body ranged from 7 to 19 mm. The unilateral horizontal facet appearance on an anteroposterior radiograph and the triple image on a CT composed of a separated fracture fragment, the base of the fractured facet, and the neighboring non-fractured facet were characteristic. All patients had neurological deficits from Frankel A to D, and were surgically treated by posterior fusion using wire or cable, or combined anterior and posterior spinal fusion. Conclusions The fracture and contralateral dislocation of the twin facet joints can cause severe neurological deficits because of its gross anterior displacement. Its plausible pathomechanism is extension force exerted to the cervical spine when it is maximally bent laterally.

Original languageEnglish
Pages (from-to)282-288
Number of pages7
JournalEuropean Spine Journal
Volume21
Issue number2
DOIs
Publication statusPublished - 2012 Feb 1

Keywords

  • Cervical spine
  • Compressive extension injury
  • Distractive flexion injury
  • Facet dislocation
  • Facet fracture
  • Neurological deficits

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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