Cervical Facet Dislocations & Fractures

Question 1

Where do the majority of cervical facet dislocation/fractures occur?

Answer 1

75% are subaxial

17% are at the C7-T1 junction; must observe the cervico-thoracic junction

Question 2

What is the mechanism for a facet dislocation?

Answer 2

Flexion-distraction injury

Question 3

When should an MRI be ordered in cervical facet dislocations?

Answer 3

1) pt with altered mental status
2) neurologic changes during closed reduction
3) prior to any open reduction (look for anterior disc herniation)

Question 4

How are cervical facet dislocations treated?

Answer 4

Depends on patient status:
If awake and cooperative; closed reduction-> (if closed reduction fails) MRI-> surgical stabilization
If obtunded; MRI-> surgical stabilization
Most can be done posterior, if there is significant anterior disc herniation then can do ACDF