Facet fracture-dislocation injuries of the cervical spine

Neurosurgery. 1992 May;30(5):661-6.


Sixty-eight patients with acute traumatic cervical facet fracture-dislocation injuries are presented. These patients represented 6.7% of all cervical spine fractures identified over a 12-year period. Thirty-one patients had unilateral facet injuries and 37 had bilateral facet injuries. Neurological morbidity was 90% and was most severe among bilateral facet injury patients (84% complete injuries). Spinal shock was identified in 13 patients and was a poor prognostic indicator for the subsequent recovery of associated neurological deficits. Closed reduction was attempted in 66 of 68 patients and was successful in 58% of the patients. Seven patients deteriorated. Open reduction-internal fixation was successful in 83% of 24 patients with a 4% morbidity. Seventy-eight percent of patients improved with rapid closed reduction, and 60% improved with open reduction-internal fixation; however, only 10 patients of the entire 68 made significant neurological recoveries. In these 10 patients, the timing of decompression-realignment appeared to be more important than the means of reduction.

MeSH terms

  • Adolescent
  • Adult
  • Cervical Vertebrae / injuries*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal
  • Humans
  • Joint Dislocations / complications
  • Joint Dislocations / diagnosis
  • Joint Dislocations / therapy*
  • Male
  • Manipulation, Orthopedic
  • Middle Aged
  • Multiple Trauma / mortality
  • Nervous System Diseases / etiology
  • Spinal Fractures / complications
  • Spinal Fractures / diagnosis
  • Spinal Fractures / mortality
  • Spinal Fractures / therapy*
  • Survival Rate
  • Traction
  • Treatment Outcome