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Articles linked to this work by shared authors, journal, and citation graph.

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Traumatic bilateral cervical facet dislocation:a comprehensive review and evidence-based treatment algorithm.

Imran Z Haq1, Michael G Fehlings2, Alexander R Vaccaro3

  • 1Consultant Neurosurgeon, National Hospital for Neurology and Neurosurgery, London, United Kingdom. Imran.haq12@nhs.net.

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
|November 9, 2025
PubMed
Summary

Traumatic bilateral cervical facet dislocation (BFD) is a severe spinal injury requiring careful management. A new algorithm guides surgeons on optimal treatment based on injury characteristics and patient status for improved outcomes.

Keywords:
AnteriorBilateral facet dislocationCervical spinePosteriorTrauma

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Spinal Surgery

Background:

  • Bilateral cervical facet dislocation (BFD) is a high-energy spinal injury.
  • It presents significant risks of neurological compromise and management challenges.

Purpose of the Study:

  • To provide a practical framework for managing traumatic BFD.
  • To synthesize current evidence on diagnostic and therapeutic strategies.

Main Methods:

  • Literature review of biomechanics, diagnostics, and surgical approaches.
  • Critical appraisal of anterior, posterior, and circumferential surgical techniques.
  • Identification of factors influencing intervention choice (e.g., disc extrusion, chronicity).

Main Results:

  • A novel treatment algorithm is proposed, integrating imaging, neurological status, and injury timing.
  • Anterior decompression and fixation is suitable for reducible injuries in neurologically intact patients.
  • Posterior-first or staged approaches may be needed for fixed or chronic dislocations.

Conclusions:

  • The presented framework aids spine surgeons in managing BFD.
  • Structured management can enhance safety, consistency, and neurological outcomes in BFD cases.