Artigo Revisado por pares

Facet Fracture-Dislocation Injuries of the Cervical Spine

1992; Lippincott Williams & Wilkins; Volume: 30; Issue: 5 Linguagem: Inglês

10.1227/00006123-199205000-00001

ISSN

1524-4040

Autores

Mark N. Hadley, Brian C. Fitzpatrick, Volker K.H. Sonntag, C M Browner,

Tópico(s)

Spine and Intervertebral Disc Pathology

Resumo

Sixty-eight patients with acute traumatic cervical facet fracture-dislocation injuries are presented. These patients represented 6.7% of all cervical spine fractures identified over a 12-year period. Thirty-one patients had unilateral facet injuries and 37 had bilateral facet injuries. Neurological morbidity was 90% and was most severe among bilateral facet injury patients (84% complete injuries). Spinal shock was identified in 13 patients and was a poor prognostic indicator for the subsequent recovery of associated neurological deficits. Closed reduction was attempted in 66 of 68 patients and was successful in 58% of the patients. Seven patients deteriorated. Open reduction-internal fixation was successful in 83% of 24 patients with a 4% morbidity. Seventy-eight percent of patients improved with rapid closed reduction, and 60% improved with open reduction-internal fixation; however, only 10 patients of the entire 68 made significant neurological recoveries. In these 10 patients, the timing of decompression-realignment appeared to be more important than the means of reduction.

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