Locked facets in the thoracic spine: report of three cases and a review

Facet dislocation is a rare finding in the thoracic spine. This article presents three cases of bilateral locked facets in the thoracic region. Two were due to car accidents and the third was secondary to a vertical fall. The level of the injury was T2-T3 in two cases and T9-T10 in the third. Two patients were completely paraplegic on admission, whereas the third was neurologically intact. All patients had various associated injuries and fractures. The diagnosis of locked facets was not suspected in any of the cases, but was later made by computerized tomography with parasagittal reconstructions. All patients underwent surgery. The radiological diagnosis was confirmed intraoperatively in two cases. The facets were relocated by manual traction in one case and by Harrington distraction in the other. Fixation and fusion were performed in all three. Stability and vertebral alignment were achieved in all cases postoperatively.