ABSTRACT

Facet dislocations of the cervical spine are frequent and and serious injuries, which may lead to quadriplegia and death. The aim of this study is to determine the ratio of the facet dislocations and the coincidence of the traumatic intervertebral disc ruptures among the subaxial cervical spine injuries. Besides, the impact of the traumatic disc rupture on the surgical treatment of these injuries is also discussed.

Thirty-nine patients with subaxial cervical spine injuries who treated in our clinic in the last ten years have been reviewed retrospectively. Unilateral and bilateral facet dislocations were found in 23 (59%) patients. Mechanisms of injury, injured levels, and neurological status of the patients, the presence of traumatic disc ruptures and the preferred treatment methods were evaluated.

Traumatic ruptures of the intervertebral discs were found in 80% of the patients with facet dislocations in our study. Thirteen per cent of the patients in our study were treated non-operatively while 22% of them were treated with anterior disc removal and anterior fusion, 30% of them were treated with anterior disc removal and anterior-posterior fusion and 35% of them were treated with closed reduction and posterior fusion.

Goal of the treatment is to reduce and to stabilize the spinal column in facet dislocations. Neurological status of the patient should be prevented during the treatment. Determination of any disc rupture at the initial period may alter the treatment option in these injuries. Neurological complications may be prevented with the excision of the intervertebral disc before any reduction attempt in the patients with incomplete neurological deficits and in neurologically intact patients.