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Unilateral cervical facet dislocation in a 9-year-old boy
Stephen A Parada1, Edward D Arrington, Kurtis L Kowalski
1Madigan Army Medical Center, 9040A Fitzsimmons Dr, Joint Base Lewis McChord, WA 98431, USA. stephen.parada@us.army.mil
Orthopedics
|December 18, 2010
Summary
This case study details the successful closed reduction of a rare unilateral facet dislocation in a 9-year-old boy, highlighting a safe treatment approach for pediatric cervical spine injuries.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Traumatology
Background:
- Unilateral facet dislocations are uncommon in children, with fewer than 10 cases reported in pediatric populations.
- This article presents the youngest patient, a 9-year-old boy, with a unilateral facet dislocation at C4/5.
Observation:
- The injury occurred during a wrestling match, resulting in a flexion/axial loading mechanism.
- Pre-reduction MRI confirmed no disk herniation or cord impingement, with an intact posterior ligamentous complex.
Findings:
- Closed reduction under general anesthesia with somatosensory-evoked potential and motor-evoked potential monitoring was successfully performed.
- The reduction utilized Gardner-Wells tongs with manual traction, slight flexion, and posterior rotation under fluoroscopy.
Implications:
- This case demonstrates a successful, minimally invasive approach for treating pediatric unilateral facet dislocations.
- The patient achieved a full range of motion and remained asymptomatic at 2-year follow-up, indicating good long-term outcomes.