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Traumatic facet joint dislocation in Western Australia.

Vivek Eranki¹, Kongposh Koul², George Mendz³

¹Royal Perth Hospital, PO BOX 218, Nedlands, WA, 6009, Australia. vivek@eranki.com.au.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|October 27, 2014

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Delayed reduction of facet joint dislocations in rural Western Australia is linked to poorer patient outcomes. This study highlights challenges in managing spinal trauma across large geographical areas, suggesting protocol improvements are needed.

Area of Science:

Orthopedic Surgery
Trauma Care
Spinal Cord Injury Research

Background:

Facet joint dislocation is a severe traumatic injury with significant clinical consequences.
Western Australia's vast geography presents challenges for timely spinal trauma management.
Delays in accessing centralized care at Royal Perth Hospital (RPH) are common for rural patients.

Purpose of the Study:

To investigate the impact of delayed diagnosis and treatment on clinical outcomes for facet joint dislocations.
To identify potential disparities in outcomes between urban and rural patients with this injury.
To inform the development of improved management protocols for spinal trauma in remote areas.

Main Methods:

Retrospective analysis of facet joint dislocations presenting to RPH over a 46-month period.

Keywords:

Cervical spine dislocation Motor vehicle accident Spinal dislocation Spinal trauma

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Data collection included patient demographics, injury mechanisms, and neurological assessments (American Spinal Injury Association - ASIA scale).

Comparison of outcomes based on geographical origin (urban vs. rural) and time to reduction.

Main Results:

A total of 51 patients were analyzed (23 urban, 28 rural).
Rural patients experienced a higher incidence of poorer neurological outcomes (ASIA C or lower) compared to urban patients.
Delayed reduction of facet joint dislocations generally correlated with less favorable final ASIA scores.

Conclusions:

Geographical distance and delayed treatment significantly impact outcomes for facet joint dislocations in Western Australia.
Centralized spinal trauma services face challenges in mitigating delays for remote populations.
The findings support the need for optimized management protocols to improve care for patients with spinal trauma in large geographical regions.