Pure thoracolumbar facet dislocation: clinical features and CT appearance

Area of Science:

• Orthopedics
• Radiology
• Neurosurgery

Background:

• Pure thoracolumbar facet dislocations are severe spinal injuries.
• Accurate diagnosis and prognosis prediction are critical for patient outcomes.

Purpose of the Study:

• To evaluate the utility of computed tomography (CT) versus radiography in diagnosing pure thoracolumbar facet dislocations.
• To compare the ability of CT and radiography in predicting the prognosis of these injuries.

Main Methods:

• Retrospective review of 29 patients with pure thoracolumbar bilateral facet dislocation.
• Comparison of plain spinal radiographs (anteroposterior and lateral views) with CT scans.
• Analysis of neurological status and surgical outcomes.

Main Results:

• Radiographs documented fracture levels but missed soft-tissue and posterior element details.
• CT provided essential information on posterior elements and spinal canal integrity.
• Pure thoracolumbar facet dislocations have a distinct appearance on axial CT scans.
• Sagittal reformation via CT is vital for evaluating these injuries.

Conclusions:

• CT significantly enhances the diagnosis of pure thoracolumbar facet dislocations compared to radiography.
• CT offers critical insights into injury extent and spinal canal status, aiding prognosis.
• Axial CT and sagittal reformation are indispensable for managing thoracolumbar facet dislocations.