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Published on: November 8, 2024
Treatment of cervical dislocation with locked facets
Ze-sheng Yu1, James J Yue, Feng Wei
1Department of Orthopaedic Surgery, Peking University Third Hospital, Beijing 100083, China. zeshengyu@yahoo.com
Chinese Medical Journal
|March 16, 2007
Summary
Rapid skull traction effectively reduces bilateral locked facets dislocations in cervical injuries. Unilateral dislocations, however, require prompt posterior open reduction for successful treatment.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Trauma Care
Background:
- Lower cervical facet dislocation is a frequent cervical spine injury.
- Facet dislocations present as unilateral or bilateral types.
- Management strategies vary based on dislocation type.
Purpose of the Study:
- To compare the efficacy of rapid skull traction for reducing unilateral versus bilateral cervical facet dislocations.
- To determine optimal treatment pathways for different types of locked facet dislocations.
Main Methods:
- Retrospective review of 38 patients with cervical facet dislocations treated between 1988-2005.
- All patients received rapid skull traction; outcomes stratified by unilateral/bilateral dislocations.
- Statistical comparison using Chi-square test; surgical management based on reduction success.
Main Results:
- Successful closed reduction rates differed significantly between unilateral (15.4%) and bilateral (88.0%) locked facets (P < 0.05).
- Rapid skull traction is highly effective for bilateral dislocations.
- Unilateral dislocations showed low success rates with traction, but responded well to posterior open reduction.
Conclusions:
- Unilateral cervical locked facet dislocations necessitate immediate posterior open reduction and instrumentation.
- Bilateral cervical locked facet dislocations can be initially managed with rapid skull traction, followed by anterior cervical discectomy and fusion if successful.
