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. 2022 Jan 7;13(1):155-158.
doi: 10.1055/s-0041-1742135. eCollection 2022 Jan.

Contiguous-Level Unilateral Cervical Spine Facet Dislocation-A Report of a Less Discussed Subtype

Sunil Kumar Das  1 , Arunkumar Sekar  1 , Srinivas Jaidev  1 , Ashis Patnaik  1 , Rabi Narayan Sahu  1
Affiliations

Contiguous-Level Unilateral Cervical Spine Facet Dislocation-A Report of a Less Discussed Subtype

Sunil Kumar Das et al. J Neurosci Rural Pract. .

Abstract

Unilateral facet dislocation of subaxial cervical spine trauma is characterized by dislocation of inferior facet of superior vertebra over the superior facet of inferior vertebra. The injury is due to high-velocity trauma and associated with instability of spinal column. Such unilateral facet dislocations occurring at multiple adjacent levels for some reason are not reported or studied frequently. We have reported two cases of multiple-level dislocation of unilateral facets managed in our hospital with a review of available literature. The injury occurs as one side of the motion segment translates and rotates around an intact facet on the contralateral side. The major mechanism of injury is distractive flexion injury with axial rotation component. The injury is associated with instability secondary to loss of the discoligamentous complex. In cases with multiple-level dislocations of unilateral cervical facets, there are multiple mechanisms associated with significant neurological injury and most of them succumb at the site of injury. Only three other cases are available in English language literature. The neurological outcome is invariably poor. Multiple-level facet dislocations of subaxial cervical spine are reported sparsely in literature. We suspect that due to high-velocity nature of these injuries, most of them succumb soon after injury and not often reported. This article reports two cases of contiguous-level unilateral facet dislocation of subaxial cervical spine with associated injuries and the outcomes with review of literature.

Keywords: multiple-level facet dislocation; subaxial cervical spine injury; traumatic spine injury.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
( A ) Grade II anterolisthesis of C4 over C5 with teardrop fractures of C7, ( B ) fracture of left C5/6 lamina (arrows), ( C ) unilateral locked facet of right-sided C4–C5, C5–C6 (asterisks), ( D ) magnetic resonance imaging extensive cord contusion and edema extending from C2 to C7 with associated listhesis, ( E and F ) postoperative three-dimensional reconstruction of computed tomography C-spine after anterior and posterior fixation.
Fig. 2
Fig. 2
( A – D ) Computed tomography of the cervical spine showed grade III anterolisthesis of C6 over C7, with sagittally split fracture of C5 and C6 body along with locked facet of right-sided C5 to C6 and left C6 to C7 (asterisk). ( E ) T2-weighted magnetic resonance imaging sagittal of the cervical spine shoeing listhesis of C6 over C7 with cord edema from C4 to C7. ( F , G ) Postoperative three-dimensional reconstruction with anterior and posterior fixation.
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