Management of post-traumatic neglected cervical facet dislocation

Area of Science:

• Orthopedics
• Neurosurgery
• Spine Surgery

Background:

• Post-traumatic cervical spine dislocations are common, with delayed presentation frequent in India due to socioeconomic and infrastructural factors.
• Late diagnosis complicates treatment and impacts neurological outcomes.
• Limited literature exists on managing neglected cervical facet dislocations.

Purpose of the Study:

• To evaluate the treatment outcomes of 15 patients with neglected post-traumatic cervical facet dislocations.
• To assess the efficacy of surgical management in this patient cohort.

Main Methods:

• Retrospective study of 15 patients with neglected cervical dislocations treated between July 2013 and June 2016.
• Surgical techniques included anterior cervical discectomy and fusion (ACDF) with posterior lateral mass screw fixation, tailored to reduction success and disco-ligamentous integrity.
• Patients underwent either ACDF alone or combined anterior and posterior procedures.

Main Results:

• All 15 patients experienced pain relief and improved neck movements.
• One patient with nerve root injury fully recovered.
• 6/11 patients with incomplete spinal cord injuries improved by one Frankel grade, and 5/11 improved by two grades.
• 3 patients with complete quadriplegia showed no neurological improvement.

Conclusions:

• Surgical management of neglected cervical dislocations provides mechanical stability and alignment.
• Effective decompression, reduction, and fixation facilitate rehabilitation and prevent deformity.
• Treatment offers a fair chance of neurological recovery, even in delayed presentations.