M Kalayci1, F Cağavi, B Açikgöz. 1. Department of Neurosurgery, Zonguldak Karaelmas University Medical School, Kozlu, Zonguldak, Turkey.
Abstract
STUDY DESIGN: Two patients with diagnosis of unilateral cervical facet fracture due to motor vehicle accident (MVA) are presented, and the literature is reviewed. OBJECTIVE: To discuss the diagnostic difficulties and management strategies in two patients with post-traumatic cervical facet fracture. SETTING: Department of Neurosurgery, Zonguldak Karaelmas University, Faculty of Medicine, Turkey. SUBJECT: Nonoperative treatment with immobilization was preferred in two female cases (33-34 years old) with diagnosis of C6-7 facet fracture following MVA. Magnetic resonance imaging (MRI) could be performed in acute period in the first case, but not in the second because of inadequate technical condition. RESULT: The first case with a good compliance to immobilization recovered without any neurological complication. However, the second case mobilized earlier and used a collar irregularly. Instability developed in the second case on the second month and surgical intervention with anterior approach was performed. CONCLUSION: The diagnosis of unilateral facet fractures is often missed and the treatment is still controversial. The compliance of the patient to cervical immobilization in nonoperative treatment plays a very important role in the development of late complications. MRI in the acute period may be useful in determining instability.
STUDY DESIGN: Two patients with diagnosis of unilateral cervical facet fracture due to motor vehicle accident (MVA) are presented, and the literature is reviewed. OBJECTIVE: To discuss the diagnostic difficulties and management strategies in two patients with post-traumatic cervical facet fracture. SETTING: Department of Neurosurgery, Zonguldak Karaelmas University, Faculty of Medicine, Turkey. SUBJECT: Nonoperative treatment with immobilization was preferred in two female cases (33-34 years old) with diagnosis of C6-7 facet fracture following MVA. Magnetic resonance imaging (MRI) could be performed in acute period in the first case, but not in the second because of inadequate technical condition. RESULT: The first case with a good compliance to immobilization recovered without any neurological complication. However, the second case mobilized earlier and used a collar irregularly. Instability developed in the second case on the second month and surgical intervention with anterior approach was performed. CONCLUSION: The diagnosis of unilateral facet fractures is often missed and the treatment is still controversial. The compliance of the patient to cervical immobilization in nonoperative treatment plays a very important role in the development of late complications. MRI in the acute period may be useful in determining instability.
Authors: Christopher Chaput; Nathan B Haile; Aditya M Muzumdar; David M Gloystein; Vasilios A Zerris; Paul J Tortolani; Mark Rahm; Mark Moldavsky; Suresh Chinthakunta; Saif Khalil Journal: Int J Spine Surg Date: 2018-03-30