Unilateral Facet Dislocation

This usually occurs in flexion accompanied by rotation injuries. The facet joint at one level is dislocated so that the inferior articular process of the upper vertebra lies anterior to the superior process of the lower vertebra. Lateral plain radiographs show anterolisthesis of the upper vertebra of less than 25%. Misalignment of the spinous processes is seen on antero-posterior views and facet dislocation is readily seen in oblique projections. These injuries may or may not be associated with a spinal cord injury.

Initial management of this injury is achieved by attempting closed reduction with cervical traction, which, if successful, can then be treated with halo vest immobilization or operative fixation through an anterior or posterior approach. Otherwise, an open reduction followed by fixation is indicated. In this case, the facets are drilled until realignment can be carried out by visual inspection. There is a concern that an acute traumatic disc might occur concurrently with this injury. This is of concern, since the patient can then worsen with closed reduction. This argument has prompted the recommendation than an MRI should be performed prior to attempts at reduction with cervical traction. If a traumatic disc is recognized, surgical removal needs to be carried out before attempts at reduction are made. The reduction can then be performed in the operating room.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

Get My Free Ebook


Post a comment