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Open reduction followed by pedicle screw fixation may be good option for cervical facet dislocations
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Good clinical and radiographic outcomes for subaxial cervical dislocations were achieved using a single posterior approach with open reduction and pedicle screw fixation, according to the results from a recently published study.
Researchers analyzed 21 consecutive patients with cervical facet dislocations, with four whose levels were affected at C3-4, two with affected levels at C4-5, five with affected levels at C5-6 and 10 affected at the C6-7 level. Using the American Spinal Injury Association (ASIA) grading system, the researchers assessed the patients’ clinical outcomes. Additionally, a comparison of the degree of subluxation and the angle of segmental lordosis between preoperative and postoperative scans was used to assess radiological outcomes.
Results showed all of the patients improved neurologically, according to the researchers. Seven patients with herniated discs as shown on MRI underwent successful removal of disc fragments. Additionally, the mean segmental angles improved from 7.3° to −5.9°, and improvement in the mean subluxation was observed, from 23.4% to 2.6%, according to the researchers.
None of the patients were observed to have instability at the index level on the dynamic radiographs at 12-month follow up, the researchers noted.
The researchers concluded a first attempt at closed reduction is desirable after cervical dislocation, but an immediate and single-stage posterior approach with open reduction and pedicle screw fixation is an appropriate option for patients who cannot have a closed reduction. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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