Progressive paralysis after bilateral facet dislocation of the cervical spine

We report 13 patients with missed bilateral facet dislocation of the lower cervical spine who subsequently developed severe spinal-cord involvement. There were more women and the patients were older than in most groups with spinal injury. The commonest cause was a fall, and paralysis appeared from six to 48 hours after injury in most patients. Ten patients made some recovery after late reduction but three remained totally paralysed. We discuss the pathogenesis of the late cord lesion and the reasons for delay in diagnosis.