View source for Cervical facet dislocation

==Background==
*When bilateral, is an [[unstable spine fractures|unstable spine injury]]

==Clinical Features==
*Generally from hyperflexion mechanism such as rapid deceleration
*Frequently associated with spinal cord injury when bilateral

==Differential Diagnosis==
{{Cervical spine injuries}}

==Workup==
*[[C-Spine X-Ray]]<ref>Diaz, J. J., Aulino, J. M., Collier, B. R., Roman, C. D., May, A. K., Miller, R. S. and Guillamondegui, O. D. (2004) ‘THE EARLY WORK-UP FOR ISOLATED LIGAMENTOUS INJURY OF THE CERVICAL SPINE: DOES CT-SCAN HAVE A ROLE?’, The Journal of Trauma: Injury, Infection, and Critical Care, 57(2), p. 453</ref>
*determine if more than 1 spinal column affected 
** 1 column = generally stable 
** 2 or more columns = unstable
*generally superior facet fx
*abnormal xray? -> get CT

==Management==
===Prehospital Immobilization===
See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]]

===Hospital===
====Bilateral====
*Unstable as whole column can sublux
*high risk for significant spinal cord injury 
*Disruption of annulus fibrosus and ant longitudinal ligament > ant displacement of spine
*Imaging
**Lateral xray: vertebral body will be displaced ~50% of its width 
*Management
**spinal precautions
**operative management: nsg vs ortho

====Unilateral====
*Relatively Stable
*Presentation
**C5/C6: C6 radiculopathy with weakness to wrist extension numbness and tingling in the thumb
**C6/C7: C7 radiculopathy with weakness to triceps and wrist flexion and numbness in index and middle finger
*Imaging
**Lateral x-ray: vertebral body will be displaced ~25% of its width
**Anterior x-ray: affected spinous process points toward side that is dislocated
*Spinal cord injury rarely occurs

==Disposition==

==See Also==
*[[Spinal Cord Trauma]]
*[[Cervical spine injuries]]

[[Category:Trauma]]
[[Category:Ortho]]