Difference between revisions of "Cervical facet dislocation"

(Created page with "==Background== *Is an unstable spine injury ==Clinical Features== ===Diagnosis=== ==Differential Diagnosis== {{Cervical spine injuries}} ==Wor...")
 
Line 1: Line 1:
 
==Background==
 
==Background==
*Is an [[unstable spine fractures|unstable spine injury]]
+
 
  
 
==Clinical Features==
 
==Clinical Features==
 
===Diagnosis===
 
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
Line 10: Line 8:
  
 
==Workup==
 
==Workup==
 
==Management==
 
===Prehospital Immobilization===
 
See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]]
 
 
===Hospital===
 
{{Unstable cervical spine fracture management}}
 
 
==Disposition==
 
*Admit
 
 
==See Also==
 
*[[Spinal Cord Trauma]]
 
*[[Neurogenic Shock]]
 
 
*[[C-Spine X-Ray]]
 
*[[C-Spine X-Ray]]
*[[Unstable spine fractures]]
 
*[[Cervical spine injuries]]
 
 
[[Category:Trauma]]
 
[[Category:Ortho]]
 
 
==[[Cervical facet dislocation]]==
 
 
*determine if more than 1 spinal column affected  
 
*determine if more than 1 spinal column affected  
 
** 1 column = generally stable  
 
** 1 column = generally stable  
Line 38: Line 15:
 
*abnormal xray? -> get CT
 
*abnormal xray? -> get CT
  
 +
==Management==
 +
===Prehospital Immobilization===
 +
See [[EBQ:Prehospital Spine Immobilization|NAEMSP National Guidelines for Spinal Immobilization]]
 +
 +
===Hospital===
 
===Bilateral===
 
===Bilateral===
 
*Unstable as whole column can sublux
 
*Unstable as whole column can sublux
Line 57: Line 39:
 
**Anterior x-ray: affected spinous process points toward side that is dislocated
 
**Anterior x-ray: affected spinous process points toward side that is dislocated
 
*Spinal cord injury rarely occurs
 
*Spinal cord injury rarely occurs
 +
 +
==Disposition==
 +
 +
==See Also==
 +
*[[Spinal Cord Trauma]]
 +
*[[Cervical spine injuries]]
 +
 +
[[Category:Trauma]]
 +
[[Category:Ortho]]

Revision as of 04:00, 2 January 2015

Background

Clinical Features

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Workup

  • C-Spine X-Ray
  • 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 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